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Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(303) 464-4500
Entity
Organization
Contact information
Practice address
11820 DESTINATION DR, BROOMFIELD, CO 80021-2518
(303) 464-4500
(303) 460-6197
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
208D00000X
General Practice Physician
—
—
208M00000X
Hospitalist Physician
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
Other
Enumeration date
11/10/2020
Last updated
07/31/2024
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