MEDICARE: PARKVIEW MEDICAL CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	010626

General Provider Information

NPI Number	:	1821449471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKVIEW MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	7901 E LOWRY BLVD
Second Line	:	MAIL STOP F402
City	:	DENVER, CO
State	:	CO
Zip	:	80230-6507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 CLUB MANOR DR STE 101
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81008-1679
Country	:	US
Telephone Number	:	719-584-4000
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JON E RIGGS
Credential	:
Telephone Number	:	719-584-4000

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	04/22/2024

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