Provider Demographics
NPI:1134115025
Name:HIGH PLAINS HOME MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:HIGH PLAINS HOME MEDICAL EQUIPMENT, INC.
Other - Org Name:HIGH PLAINS HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:806-457-1080
Mailing Address - Street 1:414 N POLK ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-5232
Mailing Address - Country:US
Mailing Address - Phone:806-457-1080
Mailing Address - Fax:806-457-1041
Practice Address - Street 1:414 N POLK ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5232
Practice Address - Country:US
Practice Address - Phone:806-457-1080
Practice Address - Fax:806-457-1041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0045003332B00000X, 332BX2000X
332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017324701Medicaid
3911270001Medicare NSC
TX3911270001Medicare NSC