Colorado Department Of Corrections
Clinic/Center, Prison Health in Canon City, CO. Organization (NPI-2).
NPI number1104716240
StatusActive
Last updated in NPPESJul 14, 2025
Details
- NPI
- 1104716240
- Entity type
- Organization (NPI-2)
- Legal business name
- Colorado Department Of Corrections
- Organization subpart
- Yes
- Enumeration date
- Jul 9, 2025
- Certification date
- Jul 14, 2025
- Last updated
- Jul 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2400X | Clinic/Center, Prison Health | – | – | Yes |
Other names
- Arrowhead Correctional Center (Other Name)
Practice location
Highway 50 East & Evans BlvdCanon City, CO 81212
Phone 719-569-5644 · Fax 719-269-5656
Mailing address
Po Box 300Cmc Medical
Canon City, CO 81215
Phone 719-269-5644
Authorized official
Randolph Maul
Chief Medical Officer
7123062821
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Other Prison Health Clinic/Center providers in Canon City, CO
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All 6 Prison Health Clinic/Center providers in Canon City · All 907 providers in Canon City
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