Provider Demographics
NPI:1225610389
Name:POUDRE VALLEY HEALTH CARE INC.
Entity Type:Organization
Organization Name:POUDRE VALLEY HEALTH CARE INC.
Other - Org Name:UCHEALTH LIFELINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, UCHEALTH NORTHERN CO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-495-7000
Mailing Address - Street 1:7901 E LOWRY BLVD # F402
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1713 QUENTIN ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7136
Practice Address - Country:US
Practice Address - Phone:720-848-9123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POUDRE VALLEY HEALTH CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-27
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No341600000XTransportation ServicesAmbulance