MEDICARE: HARRIS COUNTY HOSPITAL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0002X	Clinic Pharmacy	18715	TX

General Provider Information

NPI Number	:	1114927852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	4800 FOURNACE PL STE 600W
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-2324
Country	:	US
Telephone Number	:	346-426-0478
Fax Number	:	832-487-2766

Provider Business Practice Location Address
First Line	:	4755 ALDINE MAIL RTE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77039-5934
Country	:	US
Telephone Number	:	713-842-4314
Fax Number	:	281-985-7796

Authorized Official
Title or Position	:	EVP, CFO
Name	:	VICTORIA NIKITIN
Credential	:
Telephone Number	:	346-426-0462

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	11/21/2024

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