Healthcare Provider Details
I. General information
NPI: 1265328900
Provider Name (Legal Business Name): VALLEY HOPE MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22422 E MAIN ST
PARKER CO
80138-7267
US
IV. Provider business mailing address
PO BOX 800081
KANSAS CITY MO
64180-0081
US
V. Phone/Fax
- Phone: 303-841-7857
- Fax: 303-209-7682
- Phone: 785-877-5111
- Fax: 785-877-2322
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHY
ERBERT
Title or Position: DIR. OF CONTRACT ADMIN.
Credential:
Phone: 785-877-5111