Organization
HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Active
Organization
HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Active
Other names
Holly High Plains Dispensary
Organization subpart
No
Provider details
NPI number
Authorized official
JAY BROOKE (PRESIDENT/CEO)
(719) 336-0261
Entity
Organization
Contact information
Practice address
410 WEST COLORADO, HOLLY, CO 81047-0000
(719) 537-6642
Mailing address
410 WEST COLORADO, HOLLY, CO 81047-0000
(719) 537-6642
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
OO.0000552
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2156199
PK
—
Enumeration date
12/30/2015
Last updated
04/11/2016
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