National Provider Identifier Database

COLORADO DEPARTMENT OF CORRECTIONS
Prison Health


Contact Information

COLORADO DEPARTMENT OF CORRECTIONS
1410 W 13TH ST
PUEBLO, CO81003-1961
Phone: 719-583-5550
Fax: 719-583-5560
Website:
Specialty Taxonomy Code
* Prison Health 261QP2400X

* Indicates primary specialty

NPI Profile & details for COLORADO DEPARTMENT OF CORRECTIONS

NPI Number 1669530192
Legal business name
LBN
COLORADO DEPARTMENT OF CORRECTIONS
Authorized official RANDOLPH MAUL - (CHIEF MEDICAL OFFICER)
Entity Organization
Organization subpart Yes
Enumeration date 12/05/2006
Last updated 06/24/2025 - About 12 months ago
Sole proprietor1 Not specified
Identifiers
  • CO License #: 391

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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