HOLLY HIGH PLAINS DISPENSARY (HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED) NPI 1518322924

Pharmacy (Clinic Pharmacy) in Holly, CO

NPI 1518322924 Organization Pharmacy Clinic Pharmacy

About HOLLY HIGH PLAINS DISPENSARY (HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED)

Holly High Plains Dispensary (high Plains Community Health Center Incorporated) is a provider established in Holly, Colorado specializing in pharmacy (clinic pharmacy) . The NPI number of Holly High Plains Dispensary (high Plains Community Health Center Incorporated) is 1518322924 and was assigned on December 2015. The practitioner's primary taxonomy code is 3336C0002X with license number OO.0000552 (CO). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Holly High Plains Dispensary. The authorized official of this NPI record is Jay Brooke (President/ceo)

NPI

1518322924

Provider NameHOLLY HIGH PLAINS DISPENSARY (HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED)
Provider Location Address410 WEST COLORADO HOLLY, CO 81047
Provider Mailing Address410 WEST COLORADO HOLLY, CO 81047
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameHOLLY HIGH PLAINS DISPENSARY
Other Name TypeDoing Business As (3)
Enumeration Date12-30-2015
Last Update Date04-11-2016


Primary Taxonomy

Taxonomy Code3336C0002X
ClassificationPharmacy
TypeSuppliers
SpecializationClinic Pharmacy
License No.OO.0000552
License StateCO
Taxonomy DescriptionA pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

Business Address

HOLLY HIGH PLAINS DISPENSARY
410 WEST COLORADO
HOLLY, CO
ZIP 81047
Phone: (719) 537-6642

Get Directions


Mailing Address

HOLLY HIGH PLAINS DISPENSARY
410 WEST COLORADO
HOLLY, CO
ZIP 81047
Phone: (719) 537-6642



Authorized Official

Authorized Official Name JAY BROOKE
Authorized Official TitlePRESIDENT/CEO
Authorized Official Phone(719) 336-0261

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1333600000XSuppliersPharmacyNo

Taxonomy Description: a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
061953MEDICARE OSCAR/CERTIFICATION (06)
2156199OTHER (01)

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1841525276STANTON COUNTY HOSPITAL
Organization
Family Medicine410 WEST COLORADO
HOLLY, CO 81047
(719) 537-6042
1932596350HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED
Organization
Clinic/Center (Federally Qualified Health Center (FQHC))410 WEST COLORADO
HOLLY, CO 81047
(719) 336-0261

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.