Provider Demographics
NPI:1023587631
Name:HIGH PLAINS HCA LLC
Entity type:Organization
Organization Name:HIGH PLAINS HCA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:DYSON MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-420-0012
Mailing Address - Street 1:106 DOLPHIN TER
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-9349
Mailing Address - Country:US
Mailing Address - Phone:806-420-0012
Mailing Address - Fax:
Practice Address - Street 1:7306 SW 34TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1446
Practice Address - Country:US
Practice Address - Phone:806-420-0012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health