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Organization

PEAK VISTA COMMUNITY HEALTH CENTER

Active
Parent organization
PEAK VISTA COMMUNITY HEALTH CENTER
Other names
Peak Vista Pharmacy at Myron
Organization subpart
Yes

Provider details

NPI number
Legal business name
PEAK VISTA COMMUNITY HEALTH CENTER
Authorized official
TRACY NARVET (CFO)
(719) 344-6188
Entity
Organization

Contact information

Practice address
410 GOLD PASS HEIGHTS, COLORADO SPRINGS, CO 80906
(719) 632-5700
(719) 579-6277
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917
(719) 632-5700
(719) 579-6277

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
CO
333600000X
Pharmacy
Primary
789
CO
3336C0002X
Clinic Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2124230
PK
05
87034786
CO
Enumeration date
12/07/2009
Last updated
08/17/2018
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