High Plains Medical LLC
Organization Active NPI Community/Retail Pharmacy · Burlington, CO
NPI 1467580720 · NPPES record last updated Jul 17, 2020
Key facts
- NPI
- 1467580720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 150000003 (CO)
- Legal business name
- HIGH PLAINS MEDICAL LLC
- Practice address
- 314 14TH St
Burlington, CO 80807-1608 - Phone
- (719) 346-8851
- Fax
- (719) 346-7302
- NPI assigned
- Mar 1, 2007
- Organization subpart
- No
Authorized official
- Name
- CJ Shovlin
- Title
- Manager
- Phone
- (970) 353-3316
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 2
-
Jason A Sizer, PHARM-D
-
David G Younger, M.D
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2290602 | High Plains Medical LLC | Certificate of waiver | Sep 26, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| WB Drug |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Orthoses: Off-The-Shelf|Ostomy … | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930048126 | CO | DME Supplier - Pharmacy | 6103026927 | Practice locations: Burlington, CO |
| O20231110001157 | CO | Part B Supplier - Pharmacy | 6103026927 | Practice locations: Burlington, CO |
National Provider Directory
- Tax ID family
- High Plains Medical LLC
Locations
314 14th St
Burlington, CO 80807
Phone (719) 346-8851
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 150000003 | CO | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
314 14TH St
Burlington, CO 80807-1608
Mailing address
PO Box 1809
Greeley, CO 80632-1809
Phone (970) 353-3316
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64476227 | Medicaid | CO | |
| 0601991 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- WB Drug
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All providers in Burlington, CO · Community/Retail Pharmacy in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.