Organization
PUEBLO COMMUNITY HEALTH CENTER INC
Active
Other names
PUEBLO COMMUNITY HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MCCARTHY (COO)
(719) 543-8718
Entity
Organization
Contact information
Practice address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8718
(719) 543-6505
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8718
(719) 543-6505
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1040000066
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003414
PK
—
05
—
82150541
—
CO
Enumeration date
07/24/2006
Last updated
03/17/2017
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