# POUDRE VALLEY MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Other names:** UCHealth Medical Group, UCHealth Cancer Care and Hematology Clinic - Wray
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518597137
- **Legal business name:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Authorized official:** JANA CONROY (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (970) 237-7700

## Contact information

- **Practice address:** 1017 W 7TH ST, WRAY, CO 80758-1420
- **Practice address phone:** (970) 237-7700
- **Practice address fax:** (970) 652-2797
- **Mailing address:** 2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2020
- **Last updated:** 08/01/2024