| Pure Healthcare Of Colorado Llc | |
|
320 E Fontanero St Ste 103 Colorado Springs CO 80907-7535 | |
| (855) 550-3358 | |
| Not Available |
| Full Name | Pure Healthcare Of Colorado Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 320 E Fontanero St Ste 103, Colorado Springs, Colorado |
| Authorized Official Name and Position | Rachel Fraga (CONTRACTING MANAGER) |
| Authorized Official Contact | 8019216325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Healthcare Of Colorado Llc 4179 S Riverboat Rd Ste 220 Taylorsville UT 84123-2986 Ph: (801) 755-3387 | Pure Healthcare Of Colorado Llc 320 E Fontanero St Ste 103 Colorado Springs CO 80907-7535 Ph: (855) 550-3358 |
| NPI Number | 1609400407 |
|---|---|
| Provider Enumeration Date | 03/02/2020 |
| Last Update Date | 03/16/2023 |
| Medicare PECOS PAC ID | 8426488396 |
|---|---|
| Medicare Enrollment ID | O20200416000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609400407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | John E Storheim |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699744367 PECOS PAC ID: 3375574536 Enrollment ID: I20090729000664 |
| Provider Name | Laura Elena Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912364597 PECOS PAC ID: 8729386230 Enrollment ID: I20160418001131 |
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