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Contact Information

POUDRE VALLEY MEDICAL GROUP, LLC
525 BOB PETERS GRV STE 100
COLORADO SPRINGS, CO80909-4533
 Phone: 719-365-6800
 Fax: 719-365-5740
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for POUDRE VALLEY MEDICAL GROUP, LLC

NPI # 1104439322
LBN Legal business name POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official JANA CONROY - (DIRECTOR OF CREDENTIALING)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/27/2020
Last updated 05/22/2024 - About 2 years 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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