Organization
PARKVIEW ANCILLARY SERVICES
Active
Parent organization
PARKVIEW ANCILLARY
Other names
Parkview Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARKVIEW ANCILLARY
Authorized official
DARRIN R SMITH (SR. VP/COO)
(719) 584-4290
Entity
Organization
Contact information
Practice address
216 W 13TH ST, PUEBLO, CO 81003-3704
(719) 595-7474
(719) 595-7199
Mailing address
408 N MAIN ST, PUEBLO, CO 81003-3123
(719) 595-7417
(719) 542-0809
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07725779
—
CO
Enumeration date
10/30/2019
Last updated
10/30/2019
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