Organization
COLORADO DEPARTMENT OF CORRECTIONS
Active
Parent organization
STATE OF COLORADO
Other names
San Carlos Correctional Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF COLORADO
Authorized official
DR. RANDOLPH MAUL MD (CHIEF MEDICAL OFFICER)
(719) 306-2821
Entity
Organization
Contact information
Practice address
1410 W 13TH ST, PUEBLO, CO 81003-1961
(719) 583-5550
(719) 583-5560
Mailing address
PO BOX 3, SCCF MEDICAL, PUEBLO, CO 81002
(719) 583-5550
(719) 583-5560
Taxonomy
Speciality
Code
Description
License number
State
261QP2400X
Prison Health Clinic/Center
Primary
391
CO
Other
Enumeration date
12/05/2006
Last updated
06/24/2025
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