Healthcare Provider Details

I. General information

NPI: 1104826858
Provider Name (Legal Business Name): HARRIS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 11/21/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 N MAIN ST PHARMACY
HOUSTON TX
77009-8525
US

IV. Provider business mailing address

4800 FOURNACE PL STE 600W
BELLAIRE TX
77401-2324
US

V. Phone/Fax

Practice location:
  • Phone: 713-842-4312
  • Fax: 713-236-7130
Mailing address:
  • Phone: 346-426-0478
  • Fax: 832-487-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number02092
License Number StateTX

VIII. Authorized Official

Name: VICTORIA NIKITIN
Title or Position: EVP, CFO
Credential:
Phone: 346-426-0462