Provider Demographics
NPI:1144597097
Name:HALIBURTON HIGHLANDS HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:HALIBURTON HIGHLANDS HEALTH SERVICES CORPORATION
Other - Org Name:HHHS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEBUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:705-457-1392
Mailing Address - Street 1:7199 GELERT ROAD
Mailing Address - Street 2:BOX 115
Mailing Address - City:HALIBURTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:K0M 1S0
Mailing Address - Country:CA
Mailing Address - Phone:705-457-1392
Mailing Address - Fax:705-457-2399
Practice Address - Street 1:7199 GELERT ROAD
Practice Address - Street 2:BOX 115
Practice Address - City:HALIBURTON
Practice Address - State:ONTARIO
Practice Address - Zip Code:K0M 1S0
Practice Address - Country:CA
Practice Address - Phone:705-457-1392
Practice Address - Fax:705-457-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care