Healthcare Provider Details

I. General information

NPI: 1255744660
Provider Name (Legal Business Name): ACH EVANS-CARSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR EVANS ARMY COMMUNITY HOSPITAL
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIRCLE BLDG 7500 ROOM 1036 ATTN: TREASURERS OFFICE
FORT CARSON CO
80913-4604
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-4410
  • Fax: 719-526-5917
Mailing address:
  • Phone: 719-524-4410
  • Fax: 719-526-5917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROSEMARY GONZALEZ
Title or Position: MTF SUPPORT
Credential:
Phone: 210-536-6650