# PARKVIEW ANCILLARY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARKVIEW ANCILLARY
- **Other names:** Parkview Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285278515
- **Legal business name:** PARKVIEW ANCILLARY
- **Authorized official:** DARRIN R SMITH (SR. VP/COO)
- **Authorized official phone:** (719) 584-4290

## Contact information

- **Practice address:** 216 W 13TH ST, PUEBLO, CO 81003-3704
- **Practice address phone:** (719) 595-7474
- **Practice address fax:** (719) 595-7199
- **Mailing address:** 408 N MAIN ST, PUEBLO, CO 81003-3123
- **Mailing address phone:** (719) 595-7417
- **Mailing address fax:** (719) 542-0809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/30/2019
- **Last updated:** 10/30/2019