Provider Demographics
NPI:1366682049
Name:HARRIS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HARRIS COUNTY HOSPITAL DISTRICT
Other - Org Name:FONDREN FOUNDATION PHARMACY AT SMITH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKITIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-426-0462
Mailing Address - Street 1:4800 FOURNACE PL STE 600W
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2324
Mailing Address - Country:US
Mailing Address - Phone:346-426-0478
Mailing Address - Fax:832-487-2766
Practice Address - Street 1:2525A HOLLY HALL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4124
Practice Address - Country:US
Practice Address - Phone:713-842-4328
Practice Address - Fax:713-566-3659
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRIS COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-20
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
TX279483336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy