Organization
KAISER PERMANENTE HEALTH PLAN OF COLORADO
Active
Other names
Kaiser Permanente Pueblo North Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DENESE CLARK (REGIONAL ADMINISTRATOR)
(303) 326-6717
Entity
Organization
Contact information
Practice address
3670 PARKER BLVD, PUEBLO, CO 81008-2285
(719) 595-5367
(719) 595-5370
Mailing address
3670 PARKER BLVD, PUEBLO, CO 81008-2285
(719) 595-5367
(719) 595-5370
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
779
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121958
PK
—
Enumeration date
09/18/2009
Last updated
05/24/2021
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