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 |