Organization
PUEBLO COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD MOORE (CEO)
(719) 543-8718
Entity
Organization
Contact information
Practice address
1008 N GRAND AVE, PUEBLO, CO 81003-2916
(719) 543-8718
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8718
(719) 543-5340
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
180635
CO
Other
Enumeration date
05/08/2012
Last updated
09/06/2013
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