Organization
PUEBLO COMMUNITY HEALTH CENTER INC.
Active
Parent organization
PUEBLO COMMUNITY HEALTH CENTER INC.
Other names
Parkhill Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUEBLO COMMUNITY HEALTH CENTER INC.
Authorized official
MR. DONALD E MOORE CEO (CHIEF EXECUTIVE OFFICER)
(719) 543-8718
Entity
Organization
Contact information
Practice address
1302 E 5TH ST, PUEBLO, CO 81001-3754
(719) 543-8711
(719) 543-5340
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
0849
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05638275
—
CO
Enumeration date
06/22/2006
Last updated
09/24/2013
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