Provider Demographics
NPI:1235149402
Name:HOUSTON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:HOUSTON COUNTY HEALTH DEPARTMENT
Other - Org Name:HOUSTON COUNTY BOARD OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-751-6303
Mailing Address - Street 1:201 2ND ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-6328
Mailing Address - Country:US
Mailing Address - Phone:478-297-5190
Mailing Address - Fax:478-751-6099
Practice Address - Street 1:98 COHEN WALKER DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-0744
Practice Address - Country:US
Practice Address - Phone:478-218-2000
Practice Address - Fax:478-218-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003188424AMedicaid
GA003205022AMedicaid
GA600001601OtherMEDICARE RAILROAD
GA000733169AMedicaid
GA00051961FMedicaid
GA003161295BMedicaid
GA00460336FMedicaid
GAFLU171OtherMEDICARE PTAN
GA00051961FMedicaid
GA00460336FMedicaid
GA600001601OtherMEDICARE RAILROAD
GA00891899DMedicaid
GA600001601OtherMEDICARE RAILROAD
GAG26818Medicare UPIN
GA00891899DMedicaid