PUEBLO COMMUNITY HEALTH CENTER INC. (NPI# 1245275932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245275932 |
| Entity Type | Organization |
| Organization Name | PUEBLO COMMUNITY HEALTH CENTER INC. |
| Practice Address |
2030 Lake Avenue Pueblo CO 81004 |
| Mailing Address |
110 E Routt Ave Pueblo CO 81004-2117 |
| Practice Telephone | 7195438711 |
| Practice Fax Number | 7195435340 |
| Mailing Telephone | 7195438718 |
| Mailing Fax Number | 7195435340 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2013-09-23 |
| Authorized Official Name | MR. DONALD MOORE (CEO) |
| Authorized Official Telephone | 7195438711 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0849 | CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 05638275 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821010448 | Pueblo Community Health Center Inc. | Clinic/Center | 328 Avondale Blvd, Avondale, CO 81022 | 2006-07-24 |
| 1790966174 | Pueblo Community Health Center Inc. | Clinic/Center | 129 Kansas Ave, Walsenburg, CO 81089-1818 | 2007-11-14 |
| 1245253145 | Pueblo Community Health Center Inc. | Clinic/Center | 110 E Routt Ave, Pueblo, CO 81004-2117 | 2006-07-25 |
| 1164468336 | Pueblo Community Health Center Inc. | Clinic/Center | 1302 E 5th St, Pueblo, CO 81001-3754 | 2006-06-22 |
| 1770529950 | Pueblo Community Health Center Inc. | Clinic/Center | 300 Colorado Ave, Pueblo, CO 81004-2006 | 2006-06-22 |
| Street Address |
2030 LAKE AVENUE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607169 | Pueblo Community Health Center, Inc | Clinic/Center | 2500 W 18th St Bldg 11, Pueblo, CO 81003-1152 | 2019-06-06 |
| 1316466816 | Pueblo Community Health Center Inc | Clinic/Center | 900 W Orman Ave Rm Mt118, Pueblo, CO 81004-1430 | 2017-09-15 |
| 1720432610 | Pueblo Community Health Center, Inc | Clinic/Center | 2525 Mountview Dr, Pueblo, CO 81008-1431 | 2016-04-18 |
| 1649524653 | Pueblo Community Health Center | Clinic/Center | 9 Macneil Rd, Pueblo, CO 81001-1931 | 2012-10-30 |
| 1912251927 | Pueblo Community Health Center | Clinic/Center | 715 W 20th St, Pueblo, CO 81003-4052 | 2012-10-30 |
| 1013261023 | Pueblo Community Health Center | Clinic/Center | 625 N Monument Ave, Pueblo, CO 81001-5706 | 2012-10-30 |
| 1700139813 | Pueblo Community Health Center | Clinic/Center | 206 E Orman, Pueblo, CO 81004 | 2012-10-26 |
| 1396098828 | Pueblo Community Health Center | Clinic/Center | 1050 35th Ln, Pueblo, CO 81006-9426 | 2012-10-22 |
| 1144589425 | Pueblo Community Health Center, Inc | Clinic/Center | 1008 N Grand Ave, Pueblo, CO 81003-2916 | 2012-05-08 |
| 1245253145 | Pueblo Community Health Center Inc. | Clinic/Center | 110 E Routt Ave, Pueblo, CO 81004-2117 | 2006-07-25 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.