Provider Demographics
NPI:1508339078
Name:GREAT PLAINS DME, LLC
Entity Type:Organization
Organization Name:GREAT PLAINS DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-260-9690
Mailing Address - Street 1:926 W HARRY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-4109
Mailing Address - Country:US
Mailing Address - Phone:316-945-0040
Mailing Address - Fax:316-945-0016
Practice Address - Street 1:926 W HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-4109
Practice Address - Country:US
Practice Address - Phone:316-371-0107
Practice Address - Fax:316-945-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies