Provider Demographics
NPI:1033175179
Name:HORIZON HEALTHCARE MANAGEMENT
Entity Type:Organization
Organization Name:HORIZON HEALTHCARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNTS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:276-228-5940
Mailing Address - Street 1:185 STAFFORD UMBERGER RD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-4439
Mailing Address - Country:US
Mailing Address - Phone:276-228-5940
Mailing Address - Fax:276-228-9292
Practice Address - Street 1:185 STAFFORD UMBERGER RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-4439
Practice Address - Country:US
Practice Address - Phone:276-228-5940
Practice Address - Fax:276-228-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201003165251F00000X, 332B00000X, 332BP3500X, 3336H0001X
WVM00559211251F00000X, 332B00000X, 332BP3500X, 3336H0001X
TN0000013211251F00000X, 332B00000X, 3336H0001X
NC08170251F00000X, 332B00000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0144254000Medicaid
VA240087OtherANTHEM
NC4810493Medicaid
TN0000013211Medicaid
WV0144254001Medicaid
VA008504806Medicaid
VA009106294Medicaid
VA4827967OtherNCPDP
WV0144254001Medicaid
WV0144254001Medicaid