Healthcare Provider Details

I. General information

NPI: 1124215603
Provider Name (Legal Business Name): HOUSTON HOSPITALS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HOSPITAL DR
WARNER ROBINS GA
31088-4204
US

IV. Provider business mailing address

120 DR PARIHAR DR
WARNER ROBINS GA
31088-4204
US

V. Phone/Fax

Practice location:
  • Phone: 478-542-7981
  • Fax: 478-929-9544
Mailing address:
  • Phone: 478-542-7981
  • Fax: 478-352-4515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHRE009387
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRANDI MONTGOMERY RAYBON
Title or Position: PHARMACY SUPERVISOR/PIC
Credential: PHARMD
Phone: 478-542-7981