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General NPI Number Information
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NPI Number | 1518646520
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Entity Type | Organization
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Legal Business Name | GREAT PLAINS RESTORATIVE SERVICES, LLC
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 584 12TH ST W
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City | DICKINSON
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State | ND
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Zip | 58601-3509
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Country | US
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Telephone | 701-456-4364
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Fax | 701-456-4642
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Provider Business Mailing Address
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Address Line | 584 12TH ST W
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City | DICKINSON
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State | ND
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Zip | 58601-3509
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Country | US
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Telephone | 701-456-4364
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Fax | 701-456-4642
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Authorized Official
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Title or Position | CEO
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Name | GREGORY P LORD
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Credential |
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Telephone | 701-530-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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