Organization
EVANS ARMY COMMUNITY HOSPITAL
Active
Parent organization
EVANS ARMY COMMUNITY HOSPITAL
Other names
Mountain Post Behavioral Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVANS ARMY COMMUNITY HOSPITAL
Authorized official
ELIZABETH BURLINGAME (UBO MANAGER)
(719) 526-7291
Entity
Organization
Contact information
Practice address
6541 SPECKER AVE, BLDG 1830, FT CARSON, CO 80913-4263
(719) 526-7104
Mailing address
1650 COCHRANE CIR, ATTN THIRD PARTY OFFICE, FT CARSON, CO 80913-4613
(719) 503-7045
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497795702
PARENT BILLING FACILITY EVANS ACH NPI
—
Enumeration date
12/10/2012
Last updated
05/08/2015
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