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COLORADO COALITION FOR THE HOMELESS NPI 1689857153


NPI Information

NPI: 1689857153
Provider Name: COLORADO COALITION FOR THE HOMELESS

Doing Business As: STOUT STREET CLINIC - PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

CLIA Number: 06D2134542

Address:
2130 STOUT STREET
DENVER, CO
ZIP 80205
Phone: (303) 293-3979
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COLORADO COALITION FOR THE HOMELESS is a clinic pharmacy pharmacy in Denver, CO. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. COLORADO COALITION FOR THE HOMELESS NPI is 1689857153. The provider is registered as an organization entity type.
The provider Is Doing Business As Stout Street Clinic - Pharmacy.

The provider's business location address is:

2130 STOUT STREET
DENVER, CO
ZIP 80205-827
Phone: (303) 293-3979
Fax: (303) 293-6514

The provider's authorized official is Pete J Stoller .
The authorized official title is Cfo and has the following contact phone number (303) 312-9606.

The CLIA number assigned to this NPI record is 06D2134542 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2007 and was last updated on 10/21/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
23336C0002XPharmacyClinic PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
179000053MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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