Healthcare Provider Details

I. General information

NPI: 1902125321
Provider Name (Legal Business Name): GREAT PLAINS OF REPUBLIC CO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2010
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 G ST
BELLEVILLE KS
66935-2400
US

IV. Provider business mailing address

2420 G ST
BELLEVILLE KS
66935-2400
US

V. Phone/Fax

Practice location:
  • Phone: 785-527-2254
  • Fax: 785-527-2800
Mailing address:
  • Phone: 785-527-2254
  • Fax: 785-527-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateKS

VIII. Authorized Official

Name: MR. WESLEY A GOFORTH
Title or Position: CFO
Credential:
Phone: 785-527-6050