Poudre Valley Medical Group, LLC
Family Medicine in Colorado Springs, CO. Organization (NPI-2).
NPI number1346856473
StatusActive
Last updated in NPPESJun 16, 2024
Details
- NPI
- 1346856473
- Entity type
- Organization (NPI-2)
- Legal business name
- Poudre Valley Medical Group, LLC
- Organization subpart
- Yes
- Enumeration date
- Sep 23, 2020
- Certification date
- Jun 16, 2024
- Last updated
- Jun 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – |
Other names
- Uchealth Primary Care - Grandview (Other Name)
- Uchealth Medical Group (Doing Business As)
Practice location
5818 N Nevada Ave Ste 200Colorado Springs, CO 80918-3505
Phone 719-599-0444 · Fax 719-365-7150
Mailing address
2695 Rocky Mountain Ave Ste 150Loveland, CO 80538-9071
Authorized official
Jana Conroy
Director Of Credentialing
7195990444
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