Provider Demographics
NPI:1669898300
Name:ORIGINS CF, INC
Entity type:Organization
Organization Name:ORIGINS CF, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:V
Authorized Official - Last Name:HALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA
Authorized Official - Phone:281-402-3540
Mailing Address - Street 1:PO BOX 680563
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268-0563
Mailing Address - Country:US
Mailing Address - Phone:281-402-3540
Mailing Address - Fax:832-717-1124
Practice Address - Street 1:2800 POST OAK BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6100
Practice Address - Country:US
Practice Address - Phone:281-402-3540
Practice Address - Fax:832-717-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS183500000X
TX302F00000X
TX100071332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No302F00000XManaged Care OrganizationsExclusive Provider Organization