| Parkhill Clinic | |
|
1302 E 5th St Pueblo CO 81001-3754 | |
| (719) 543-8711 | |
| (719) 543-5340 |
| Full Name | Parkhill Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1302 E 5th St, Pueblo, Colorado |
| Authorized Official Name and Position | Donald E Moore (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7195438718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkhill Clinic 110 E Routt Ave Pueblo CO 81004-2117 Ph: (719) 543-8718 | Parkhill Clinic 1302 E 5th St Pueblo CO 81001-3754 Ph: (719) 543-8711 |
| NPI Number | 1164468336 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 4284543802 |
|---|---|
| Medicare Enrollment ID | O20091116000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164468336 | NPI | - | NPPES |
| 05638275 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0849 (Colorado) | Primary |
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