Provider Demographics
NPI:1700360831
Name:HOUSTON COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:HOUSTON COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-751-6303
Mailing Address - Street 1:320 S POLK ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-1436
Mailing Address - Country:US
Mailing Address - Phone:806-242-7782
Mailing Address - Fax:478-238-9417
Practice Address - Street 1:158 EMERY HWY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3656
Practice Address - Country:US
Practice Address - Phone:478-216-5783
Practice Address - Fax:478-238-9417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003218769AMedicaid