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Contact Information

POUDRE VALLEY MEDICAL GROUP, LLC
525 BOB PETERS GRV STE 309
COLORADO SPRINGS, CO80909-4533
 Phone: 719-365-6464
 Fax: 719-365-7551
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecologic Oncology

207VX0201X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for POUDRE VALLEY MEDICAL GROUP, LLC

NPI Number 1538774229
LBN Legal business name POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official JANA CONROY - (DIRECTOR OF CREDENTIALING)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/10/2020
Last updated 08/01/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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