OrganizationActive
Colorado Department of Corrections
NPI 1669530192 · Prison Health Clinic/Center · Pueblo, CO
Provider details
- NPI number
- 1669530192
- Entity type
- Organization
- Primary specialty
- Prison Health Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- State of Colorado
- Authorized official
- Randolph Maul, Chief Medical Officer
- License
- 391 (CO)
Practice location
1410 W 13th St
Pueblo, CO 81003-1961
Phone: (719) 583-5550
Fax: (719) 583-5560
Mailing address
Po Box 3
Pueblo, CO 81002
Registry dates
- Enumerated
- 2006-12-05
- Last updated
- 2025-06-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.