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Poudre Valley Medical Group, LLC

Organization Active NPI Hematology & Oncology Physician · Colorado Springs, CO

NPI 1720822232 · NPPES record last updated Jun 20, 2024

Key facts

NPI
1720822232
Entity type
Organization (NPI type 2)
Primary specialty
Hematology & Oncology Physician 207RH0003X
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Practice address
1400 E Boulder St Ste 1150
Colorado Springs, CO 80909-5533
Phone
(719) 365-5572
Fax
(719) 365-5129
NPI assigned
Jun 20, 2024
Organization subpart
Yes
Parent organization (as reported)
POUDRE VALLEY MEDICAL GROUP, LLC

Authorized official

Name
Jana Conroy
Title
Director of Credentialing
Phone
(719) 365-5572

Corporate family (same tax ID) 24

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Poudre Valley Medical LLC (282 organizations share this tax ID)
Part of
Poudre Valley Medical LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RH0003X Yes

Addresses

Primary practice location

1400 E Boulder St Ste 1150
Colorado Springs, CO 80909-5533

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Other names

  • UCHealth Medical Group Doing business as

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Hematology & Oncology Physician in Colorado

Sources for this page

Verify at the official NPI Registry.