Organization
COLO STATE DEPT OF C ORRECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARY SHAMES (MCO)
(303) 307-2600
Entity
Organization
Contact information
Practice address
3600 HAVANA, DENVER, CO 80236
(303) 307-2600
Mailing address
3600 HAVANA ST, DENVER, CO 80239-3266
(303) 307-2600
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1380
CO
Other
Enumeration date
12/11/2006
Last updated
08/22/2020
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