Organization
EVANS ARMY COMMUNITY HOSPITAL
Active
Parent organization
EVANS ARMY COMMUNITY HOSPITAL
Other names
PUEBLO CIV EMP HLTH 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
45825 E STATE HIGHWAY 96, PUEBLO, CO 81006-9330
(719) 526-7000
Mailing address
1650 COCHRANE CIR, ATTN THIRD PARTY OFFICE, FT CARSON, CO 80913-4603
(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 FACILITY NPI 2
—
Enumeration date
05/09/2007
Last updated
04/01/2014
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