Organization
COLORADO COALITION FOR THE HOMELESS
Active
Other names
Stout Street Health Center, Stout Street Clinic - Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PETE J STOLLER (CFO)
(303) 312-9606
Entity
Organization
Contact information
Practice address
2130 STOUT STREET, DENVER, CO 80205-2827
(303) 293-3979
(303) 293-6514
Mailing address
2130 STOUT STREET, DENVER, CO 80205-2827
(303) 293-3979
(303) 293-6514
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79000053
—
CO
Enumeration date
12/07/2007
Last updated
10/21/2021
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