Organization
HIGH PLAINS MEDICAL LLC
Active
Other names
WB Drug
Organization subpart
No
Provider details
NPI number
Authorized official
CJ SHOVLIN (MANAGER)
(970) 353-3316
Entity
Organization
Contact information
Practice address
314 14TH ST, BURLINGTON, CO 80807-1608
(719) 346-8851
(719) 346-7302
Mailing address
PO BOX 1809, GREELEY, CO 80632-1809
(970) 353-3316
(970) 353-3316
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
150000003
CO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601991
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
64476227
—
CO
Enumeration date
03/01/2007
Last updated
07/17/2020
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