Provider Demographics
NPI:1609240894
Name:HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Entity Type:Organization
Organization Name:HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Other - Org Name:FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-336-0261
Mailing Address - Street 1:200 KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:CO
Mailing Address - Zip Code:81052-3940
Mailing Address - Country:US
Mailing Address - Phone:719-336-0261
Mailing Address - Fax:719-336-0265
Practice Address - Street 1:200 KENDALL DR
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:CO
Practice Address - Zip Code:81052-3940
Practice Address - Country:US
Practice Address - Phone:719-336-0261
Practice Address - Fax:719-336-0265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-25
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization