NPIMap

Organization Active NPI

Pueblo Community Health Center Inc

  • Community/Retail Pharmacy
  • Pueblo, CO
National Provider Identifier
1790730737
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
650 Issued in CO
Legal business name
PUEBLO COMMUNITY HEALTH CENTER INC
Practice address
1301 E 7TH St
Pueblo, CO 81001
Phone
(719) 476-0220
Fax
(719) 545-5587
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Justin McCarthy
Title
Coo
Phone
(719) 543-8718

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 650 CO Primary

Addresses

Primary practice location

1301 E 7TH St
Pueblo, CO 81001

Mailing address

1302 E 5TH St
Pueblo, CO 81001-3754
Phone (719) 476-0220

Other identifiers 2

IdentifierTypeStateIssuer
2003867OtherPK
88408884MedicaidCO

Other names 1

  • PUEBLO COMMUNITY HEALTH CENTER PARK HILL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pueblo Community Health17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

1301 E 7th St
Pueblo, CO 81001
Phone (719) 250-6314

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1790730737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 E 5TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810013754",
            "telephone_number": "719-476-0220",
            "fax_number": "719-545-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E 7TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81001",
            "telephone_number": "719-476-0220",
            "fax_number": "719-545-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "719-543-8718"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2003867",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88408884",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PUEBLO COMMUNITY HEALTH CENTER PARK HILL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PUEBLO COMMUNITY HEALTH CENTER PARK HILL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.