Healthcare Provider Details

I. General information

NPI: 1174532220
Provider Name (Legal Business Name): HEALTH AND HUMAN SERVICES COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N US HIGHWAY 87
BIG SPRING TX
79720-0283
US

IV. Provider business mailing address

1901 N US HIGHWAY 87
BIG SPRING TX
79720-0283
US

V. Phone/Fax

Practice location:
  • Phone: 432-268-7289
  • Fax: 432-268-7245
Mailing address:
  • Phone: 432-268-7289
  • Fax: 432-268-7245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number06005
License Number StateTX

VIII. Authorized Official

Name: JANA JOHNSON
Title or Position: PROGRAM SPECIALIST VI
Credential:
Phone: 512-438-3124