Poudre Valley Medical Group, LLC
Organization Active NPI Cardiovascular Disease Physician · Eads, CO
NPI 1356972301 · NPPES record last updated Jul 24, 2024
Key facts
- NPI
- 1356972301
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- POUDRE VALLEY MEDICAL GROUP, LLC
- Practice address
- 1208 Luther Street
Eads, CO 81036-0817 - Phone
- (719) 438-5401
- Fax
- (719) 438-5697
- NPI assigned
- Jan 29, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
- Name
- Jana Conroy
- Title
- Director of Credentialing
- Phone
- (719) 438-5401
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Poudre Valley Medical LLC
- Part of
- Poudre Valley Medical LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes | ||
| Clinical Cardiac Electrophysiology Physician |
207RC0001X |
Addresses
Primary practice location
1208 Luther Street
Eads, CO 81036-0817
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Other names
- UCHealth Medical Group
- UCHealth Heart and Vascular Clinic - Eads
Other providers in Eads, CO
- Kiowa Home Health Services
- Luar Arjay Du Legua
- Lindsey Marie Counseling, PLLC
- Robert Todd Michael
- Pharmacy Services Inc.
- Prairie Pines
- Erik David Ritch
- Southeast Mental Health Services
- Southeast Mental Health Services
- Valley-Wide Health Systems, Inc.
All providers in Eads, CO · Cardiovascular Disease Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.