# POUDRE VALLEY MEDICAL GROUP, LLC

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

## Provider details

- **NPI number:** 1669001822
- **Legal business name:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Authorized official:** JANA CONROY (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (719) 365-6568

## Contact information

- **Practice address:** 525 BOB PETERS GRV STE 202, COLORADO SPRINGS, CO 80909-4533
- **Practice address phone:** (719) 365-6568
- **Practice address fax:** (719) 365-6317
- **Mailing address:** 2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
- **Mailing address phone:** (719) 365-6568
- **Mailing address fax:** (719) 365-6317

## Taxonomy

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

## Other

- **Enumeration date:** 04/08/2020
- **Last updated:** 08/05/2024