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General NPI Number Information
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NPI Number | 1427328426
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Entity Type | Organization
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Legal Business Name | SOUTH PLATTE RIVER HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 603 W MAIN ST
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City | STERLING
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State | CO
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Zip | 80751-2919
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Country | US
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Telephone | 970-867-4997
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Fax | 970-867-8430
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Provider Business Mailing Address
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Address Line | 201 MAIN ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-2106
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Country | US
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Telephone | 970-867-4997
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Fax | 970-967-8430
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHARON KAY MEINTS
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Credential |
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Telephone | 970-867-4997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 19871540393
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 19871540393
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 19871540393
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License Number State | CO
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