Organization
PUEBLO COMMUNITY HEALTH CENTER
Active
Other names
East High School SBWC
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD MOORE (CEO)
(719) 543-8711
Entity
Organization
Contact information
Practice address
9 MACNEIL RD, PUEBLO, CO 81001-1931
(719) 543-8711
(719) 543-5340
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8711
(719) 543-5340
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/30/2012
Last updated
11/19/2012
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