Provider Demographics
NPI:1083979660
Name:PLAINS MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:PLAINS MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HONEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-775-2367
Mailing Address - Street 1:820 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:LIMON
Mailing Address - State:CO
Mailing Address - Zip Code:80828-1120
Mailing Address - Country:US
Mailing Address - Phone:719-775-2367
Mailing Address - Fax:719-775-8626
Practice Address - Street 1:320 COMANCHE STREET
Practice Address - Street 2:
Practice Address - City:KIOWA
Practice Address - State:CO
Practice Address - Zip Code:80117
Practice Address - Country:US
Practice Address - Phone:720-389-9763
Practice Address - Fax:720-328-0912
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLAINS MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-10
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7203899763OtherTELEPHONE NUMBER-KIOWA