Healthcare Provider Details

I. General information

NPI: 1700360831
Provider Name (Legal Business Name): HOUSTON COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 EMERY HWY
MACON GA
31217-3656
US

IV. Provider business mailing address

320 S POLK ST STE 200
AMARILLO TX
79101-1436
US

V. Phone/Fax

Practice location:
  • Phone: 478-216-5783
  • Fax: 478-238-9417
Mailing address:
  • Phone: 806-242-7782
  • Fax: 478-238-9417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE MCNAIR
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 478-751-6303