# 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 Primary Care - Interquest
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881390045
- **Legal business name:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Authorized official:** JANA CONROY (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (719) 364-1650

## Contact information

- **Practice address:** 1370 INTERQUEST PKWY, SUITE 210, COLORADO SPRINGS, CO 80921-4339
- **Practice address phone:** (719) 364-1650
- **Practice address fax:** (719) 364-1651
- **Mailing address:** 2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/31/2023
- **Last updated:** 08/19/2024