Provider Demographics
NPI:1619060803
Name:GREAT PLAINS MEDICAL, INC.
Entity Type:Organization
Organization Name:GREAT PLAINS MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:913-764-3800
Mailing Address - Street 1:1849 S RIDGEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2288
Mailing Address - Country:US
Mailing Address - Phone:913-764-3800
Mailing Address - Fax:913-764-3861
Practice Address - Street 1:1849 S RIDGEVIEW RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2288
Practice Address - Country:US
Practice Address - Phone:913-764-3800
Practice Address - Fax:913-764-3861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100459210AMedicaid
KS32866019OtherBC/BS
KS32866019OtherBC/BS