| NPI | 1689857153 |
|---|---|
| Doing Business As | STOUT STREET HEALTH CENTER |
| Doing Business As | STOUT STREET CLINIC - PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PETE J STOLLER CFO 303-312-9606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2021-10-21 |