Stout Street Clinic - Pharmacy

LBN: Colorado Coalition For The Homeless
Stout Street Clinic - Pharmacy is an health care organization with primary practice located at 2130 Stout Street , Denver CO 80205-2827. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Suppliers / Clinic Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Colorado Coalition For The Homeless can be contacted via phone (303) 293-3979, or through Stoller, Pete J via phone (303) 312-9606.

Contact Information

Primary practice address
2130 Stout Street Denver CO 80205-2827
Phone: (303) 293-3979
Fax: (303) 293-6514
Website:
Map and Directions
Authorized official contact:
Name: Stoller, Pete J
Phone: (303) 312-9606

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Suppliers / Clinic Pharmacy 3336C0002X

Profile Details

NPI number 1689857153
LBN Legal business name Colorado Coalition For The Homeless
DBA Doing business as Stout Street Clinic - Pharmacy
Authorized official Stoller, Pete J
Entity Organization
Organization subpart 1 No
Enumeration date Dec 7th, 2007
Last updated Oct 21st, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689857153 NPPES
Colorado MEDICAID 79000053

Popular Providers