NPIMap

Organization Active NPI

Poudre Valley Health Care Inc

  • Community/Retail Pharmacy
  • Fort Collins, CO
National Provider Identifier
1154706554
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PDO31680000097 Issued in CO
Legal business name
POUDRE VALLEY HEALTH CARE INC
Practice address
4630 Snow Mesa Dr
Fort Collins, CO 80528-8508
Phone
(970) 237-8140
NPI assigned
Jul 27, 2015
Last updated
Jan 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
POUDRE VALLEY HEALTH CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Thompson
Title
Cfo
Phone
(970) 237-8100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PDO31680000097 CO Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

4630 Snow Mesa Dr
Fort Collins, CO 80528-8508

Mailing address

7901 E Lowry Blvd
Mail Stop F402
Denver, CO 80230-6507

Other identifiers 1

IdentifierTypeStateIssuer
10080252MedicaidAZ

Other names 1

  • Harmony Emergency Department Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Poudre Valley HLTH Care Inc21 organizations share this tax ID, including this one
Part of
Poudre Valley HLTH Care Inc

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1154706554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 E LOWRY BLVD",
            "address_2": "MAIL STOP F402",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802306507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 SNOW MESA DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288508",
            "telephone_number": "970-237-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY HEALTH CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POUDRE VALLEY HEALTH CARE INC",
        "enumeration_date": "2015-07-27",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-237-8100"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "PDO31680000097",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10080252",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harmony Emergency Department Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.