Organization
PUEBLO COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNALD MOORE (CEO)
(719) 543-8711
Entity
Organization
Contact information
Practice address
300 COLORADO AVE, PUEBLO, CO 81004-2006
(719) 543-8711
(719) 543-5340
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 543-5340
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
50145
CO
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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