Provider Demographics
NPI:1891808499
Name:HOUSTON HOSPITALS INC
Entity Type:Organization
Organization Name:HOUSTON HOSPITALS INC
Other - Org Name:PERRY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHILDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-542-7959
Mailing Address - Street 1:1601 WATSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3431
Mailing Address - Country:US
Mailing Address - Phone:478-922-4281
Mailing Address - Fax:478-322-5174
Practice Address - Street 1:1120 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-2906
Practice Address - Country:US
Practice Address - Phone:478-987-3600
Practice Address - Fax:478-322-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076-655275N00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000001471AMedicaid
GA224OtherBLUE CROSS PROVIDER NUMBE
GA000001471AMedicaid
GA110153Medicare Oscar/Certification