Organization
BOULDER MEDICAL CENTER, PC
Active
Other names
Boulder Medical Center ASC
Organization subpart
No
Provider details
NPI number
Authorized official
CASANDRA RICHARDS (CREDENTIALING COORDINATOR)
(303) 440-3076
Entity
Organization
Contact information
Practice address
2750 BROADWAY ST, BOULDER, CO 80304-3573
(303) 440-3000
Mailing address
2750 BROADWAY ST, BOULDER, CO 80304-3573
(303) 440-3000
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
160365
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160365
STATE LICENSE AS AMBULATORY SURGICAL CENTER
CO
Enumeration date
08/05/2008
Last updated
04/29/2026
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