# PEAK VISTA COMMUNITY HEALTH CENTERS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PEAK VISTA COMMUNITY HEALTH CENTERS
- **Other names:** Peak Vista Pharmacy at Academy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912240540
- **Legal business name:** PEAK VISTA COMMUNITY HEALTH CENTERS
- **Authorized official:** PAMELA MCMANUS (PRESIDENT & CEO)
- **Authorized official phone:** (791) 344-6453

## Contact information

- **Practice address:** 3207 N ACADEMY BLVD, SUITE 1200, COLORADO SPRINGS, CO 80917
- **Practice address phone:** (719) 632-5700
- **Mailing address:** 3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917
- **Mailing address phone:** (719) 344-6914
- **Mailing address fax:** (719) 344-7865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | PDO.1680000025 | CO | — |
| 333600000X | Pharmacy | — | CO | Yes |

## Other

- **Enumeration date:** 04/02/2013
- **Last updated:** 04/21/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05638267 | — | CO |
| 05 | — | 9000143434 | — | CO |