PUEBLO COMMUNITY HEALTH CENTER (NPI# 1396098828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396098828 |
| Entity Type | Organization |
| Organization Name | PUEBLO COMMUNITY HEALTH CENTER |
| Other Organization Name | #70 SBWC |
| Practice Address |
1050 35th Ln Pueblo CO 81006-9426 |
| Mailing Address |
110 E Routt Ave Pueblo CO 81004-2117 |
| Practice Telephone | 7195438711 |
| Practice Fax Number | 7195435340 |
| Mailing Telephone | 7195438711 |
| Mailing Fax Number | 7195435340 |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2012-11-19 |
| Authorized Official Name | DONALD MOORE (CEO) |
| Authorized Official Telephone | 7195438711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| #70 SBWC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1013271329 | Pueblo Community Health Center | Health Maintenance Organization | 300 Colorado Ave, Pueblo, CO 81004-2006 | 2012-07-02 |
| Street Address |
1050 35TH LN |
| City | PUEBLO |
| State | CO |
| Zip Code | 81006-9426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023667268 | Shelby Bley | Specialist/Technologist | 1050 35th Ln, Pueblo, CO 81006-9426 | 2019-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181760 | Kaitlyn Pullara | Registered Nurse | 1 El Pueblo Way, Pueblo, CO 81006 | 2020-10-13 |
| 1528593167 | Melissa Dasher | Dental Hygienist | 1292 Zinno Blvd, Pueblo, CO 81006 | 2017-04-20 |
| 1043588833 | Johnathan Seamus Waters | Radiologic Technologist | 2223 Daniel Road, Pueblo, CO 81006 | 2011-12-07 |
| 1992858344 | El Pueblo Boys' and Girls' Ranch, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1 El Pueblo Ranch Way, Pueblo, CO 81006 | 2007-01-19 |
| 1740347996 | Jose Luis Ramirez | Physician Assistant | 45825 Highway 96 East, Pueblo, CO 81006 | 2007-01-03 |
| 1730514019 | Tammy Kay Salmon | Social Worker | 1 El Pueblo Ranch Way, Pueblo, CO 81006 | 2013-09-05 |
| 1518062074 | American Medical Response of Colorado Inc | Ambulance | 922 S Santa Fe Ave, Pueblo, CO 81006-1125 | 2006-09-13 |
| 1255654935 | B-4 Day Program and Residential Services Inc. | Day Training, Developmentally Disabled Services | 110 Santa Fe Dr, Pueblo, CO 81006-1174 | 2010-03-09 |
| 1467083022 | Stephanie Ortega | Counselor | 1591 Taos Rd, Pueblo, CO 81006-1232 | 2020-01-31 |
| 1053918623 | Health Solutions | Clinic/Center | 1591 Taos Rd, Pueblo, CO 81006-1232 | 2020-10-06 |
| Find all providers in zip 81006 | ||||
| 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 |
| 1245275932 | Pueblo Community Health Center Inc. | Clinic/Center | 2030 Lake Avenue, Pueblo, CO 81004 | 2006-06-18 |
| 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.