Organization
COLORADO MENTAL HEALTH INSTITUTE FORT LOGAN
Active
Other names
CMHIFL
Organization subpart
No
Provider details
NPI number
Authorized official
KAT FOO (COMPLIANCE OFFICER)
(303) 866-5871
Entity
Organization
Contact information
Practice address
3520 W OXFORD AVE, DENVER, CO 80236-3108
(303) 866-7149
Mailing address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4000
(719) 546-4484
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0602943
NCPDP MEDICARE PART D
CO
Enumeration date
12/07/2006
Last updated
08/22/2020
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