MEDICARE: BOULDER COMMUNITY HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1306586276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOULDER COMMUNITY HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 9049
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-9049
Country	:	US
Telephone Number	:	303-415-5300
Fax Number	:	303-415-4769

Provider Business Practice Location Address
First Line	:	1000 W SOUTH BOULDER RD STE 214C
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-2089
Country	:	US
Telephone Number	:	303-415-5399
Fax Number	:	303-297-5808

Authorized Official
Title or Position	:	VP, CFO
Name	:	WILLIAM A MUNSON JR.
Credential	:
Telephone Number	:	303-485-7433

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	04/22/2026

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Directions to “BOULDER COMMUNITY HEALTH ” Practice Location

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