Healthcare Provider Details

I. General information

NPI: 1609240894
Provider Name (Legal Business Name): HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2015
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 KENDALL DR
LAMAR CO
81052-3940
US

IV. Provider business mailing address

200 KENDALL DR
LAMAR CO
81052-3940
US

V. Phone/Fax

Practice location:
  • Phone: 719-336-0261
  • Fax: 719-336-0265
Mailing address:
  • Phone: 719-336-0261
  • Fax: 719-336-0265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: ANGELA WOODWARD
Title or Position: DIRECTOR HIM
Credential:
Phone: 719-691-6108