Provider Demographics
NPI:1174532220
Name:HEALTH AND HUMAN SERVICES COMMISSION
Entity type:Organization
Organization Name:HEALTH AND HUMAN SERVICES COMMISSION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPECIALIST VI
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-438-3124
Mailing Address - Street 1:1901 N US HIGHWAY 87
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-0283
Mailing Address - Country:US
Mailing Address - Phone:432-268-7289
Mailing Address - Fax:432-268-7245
Practice Address - Street 1:1901 N US HIGHWAY 87
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-0283
Practice Address - Country:US
Practice Address - Phone:432-268-7289
Practice Address - Fax:432-268-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3336I0012X
TX060053336L0003X, 3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2098738OtherPK
TX137918205Medicaid
TX137918207Medicaid