Provider Demographics
NPI:1871516146
Name:GREAT PLAINS OF REPUBLIC COUNTY, INC.
Entity type:Organization
Organization Name:GREAT PLAINS OF REPUBLIC COUNTY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BLAINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-527-2254
Mailing Address - Street 1:2420 G ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66935-2400
Mailing Address - Country:US
Mailing Address - Phone:785-527-2254
Mailing Address - Fax:785-527-2800
Practice Address - Street 1:2420 G ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:KS
Practice Address - Zip Code:66935-2400
Practice Address - Country:US
Practice Address - Phone:785-527-2254
Practice Address - Fax:785-527-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS012262OtherBLUE SHIELD OF KS