Provider Demographics
NPI:1871692889
Name:HIGH PLAINS CLINIC LLC
Entity type:Organization
Organization Name:HIGH PLAINS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:REINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-995-6111
Mailing Address - Street 1:1315 TIBBALS ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1257
Mailing Address - Country:US
Mailing Address - Phone:308-995-6111
Mailing Address - Fax:308-995-4868
Practice Address - Street 1:1315 TIBBALS ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1257
Practice Address - Country:US
Practice Address - Phone:308-995-6111
Practice Address - Fax:308-995-4868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE5766800001Medicare NSC