# GREAT PLAINS RESTORATIVE SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366120057
- **Authorized official:** GREGORY PAUL LORD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (701) 530-4000

## Contact information

- **Practice address:** 1212 E MAIN AVE, BISMARCK, ND 58501-4518
- **Practice address phone:** (701) 530-4000
- **Practice address fax:** (701) 530-4001
- **Mailing address:** 1212 E MAIN AVE, BISMARCK, ND 58501-4518
- **Mailing address phone:** (701) 530-4000
- **Mailing address fax:** (701) 530-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |
| 332BD1200X | Dialysis Equipment & Supplies (DME) | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 07/11/2023
- **Last updated:** 01/27/2025