HOUSTON COUNTY HEALTHCARE AUTHORITY (NPI# 1114161601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114161601 |
| Entity Type | Organization |
| Organization Name | HOUSTON COUNTY HEALTHCARE AUTHORITY |
| Other Organization Name | SOUTHEAST REFERENCE SERVICES |
| Practice Address |
1108 Ross Clark Cir Dothan AL 36301-3022 |
| Mailing Address |
Po Box 1928 Dothan AL 36302-1928 |
| Practice Telephone | 3347938048 |
| Practice Fax Number | 3347123122 |
| Mailing Telephone | 3347938048 |
| Mailing Fax Number | 3347123122 |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2012-07-20 |
| Authorized Official Name | DEBORAH S. WOODHAM (CONTRACT MANAGER) |
| Authorized Official Telephone | 3347938087 |
| Authorized Official Credential | CPC |
| Is Organization Subpart | Y |
| Parent Organization Name | HOUSTON COUNTY HEALTHCARE AUTHORITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 200812031750 | AL | Laboratories |
| Other Name | Type Code |
|---|---|
| Southeast Reference Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255876181 | Houston County Healthcare Authority | Family Medicine | 4550 W Main St, Suite 1, Dothan, AL 36305-1130 | 2017-01-02 |
| 1144469438 | Houston County Healthcare Authority | Nurse Practitioner | 1806 Fairview Ave Ste A, Dothan, AL 36301-3026 | 2009-02-11 |
| 1033399910 | Houston County Healthcare Authority | Durable Medical Equipment & Medical Supplies | 231 E Barbour St, Eufaula, AL 36027-1601 | 2007-11-08 |
| 1063567329 | Houston County Healthcare Authority | Durable Medical Equipment & Medical Supplies | 1109 Boll Weevill Circle, Suite 3, Enterprise, AL 36330-2063 | 2007-01-24 |
| 1457302218 | Houston County Healthcare Authority | Durable Medical Equipment & Medical Supplies | 2253 Third Ave, Suite 1, Dothan, AL 36301-5303 | 2006-05-15 |
| 1164403861 | Houston County Healthcare Authority | General Acute Care Hospital | 1108 Ross Clark Circle, Dothan, AL 36301-3022 | 2005-11-09 |
| 1275047094 | Houston County Healthcare Authority | Internal Medicine | 1118 Ross Clark Cir Ste 200, Dothan, AL 36301-3029 | 2017-12-01 |
| 1881057974 | Houston County Healthcare Authority | Surgery | 1812 E Main St, Dothan, AL 36301-3000 | 2016-04-05 |
| 1285097477 | Houston County Healthcare Authority | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1812 E Main St, Dothan, AL 36301-3000 | 2016-04-04 |
| 1306205497 | Houston County Healthcare Authority | Social Worker | 1450 Ross Clark Cir, Suite 400a, Dothan, AL 36301-4765 | 2016-02-17 |
| Street Address |
1108 ROSS CLARK CIR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-3022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679576268 | Judith L Bosse | Nurse Practitioner | 1108 Ross Clark Cir, Hospitalist Office, Dothan, AL 36301-3022 | 2005-05-27 |
| 1811597073 | Michael Brian Pierce | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-10-27 |
| 1659990901 | Robert Dale Garrett | Nurse Anesthetist, Certified Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-04-15 |
| 1861028607 | Richard Henry Jester | Physician Assistant | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-03-12 |
| 1467017335 | Keaton Peak | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301 | 2019-05-07 |
| 1396214060 | Shalita Clark | Psychiatry & Neurology | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2018-11-24 |
| 1619452760 | Drew Mckenzie Hubbard | Registered Nurse | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2018-09-25 |
| 1609359926 | Amber Salmon | Dietitian, Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3024 | 2018-09-12 |
| 1255825832 | Shannon Louette Skaug | Nurse Practitioner | 1108 Ross Clark Cir, Dothan, AL 36301-3024 | 2018-06-18 |
| 1225529712 | Vyshnavi Kone | Student in an Organized Health Care Education/Training Program | 1108 Ross Clark Cir, Dothan, AL 36301 | 2018-05-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285612473 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1034 Ross Clark Cir, Dothan, AL 36303-5485 | 2006-01-06 |
| 1427555226 | Laboratory Corportation of America Holdings | Clinical Medical Laboratory | 4300 W Main St Ste 102, Dothan, AL 36305-1306 | 2018-04-09 |
| 1992202741 | Laboratory Corportation of America Holdings | Clinical Medical Laboratory | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2018-04-09 |
| 1679835532 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-06-15 |
| 1710921416 | Triad of Alabama LLC | Clinical Medical Laboratory | 4370 W Main St, Dothan, AL 36305-1056 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908626 | Matrix Labs | Clinical Medical Laboratory | 4100 Mcclellan Blvd Ste 102, Anniston, AL 36201-2132 | 2020-10-06 |
| 1619574621 | Prestige Laboratory Services | Clinical Medical Laboratory | 857 Downtowner Blvd Ste H, Mobile, AL 36609-5420 | 2020-10-02 |
| 1740897123 | Labs Plus, LLC | Clinical Medical Laboratory | 2701 Mall Dr Ste 7204, Florence, AL 35630-7502 | 2020-09-29 |
| 1841800232 | Amh Staffing Agency | Clinical Medical Laboratory | 9925 County Road 63, Plantersville, AL 36758-2853 | 2020-07-31 |
| 1861012361 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 129 Mitylene Park Lane, Montgomery, AL 36117-3758 | 2020-04-24 |
| 1407487465 | Golden Point Solutions LLC | Clinical Medical Laboratory | 411a Lorna Sq, Vestavia Hills, AL 35216-5418 | 2020-01-29 |
| 1386284156 | Magnolia Diagnostic Laboratories, LLC | Clinical Medical Laboratory | 2868 Acton Rd Ste 205, Vestavia, AL 35243-2502 | 2020-01-09 |
| 1780220863 | Sharon Masters | Clinical Medical Laboratory | 1930 Edwards Lake Rd Ste 138, Birmingham, AL 35235-3720 | 2019-11-23 |
| 1518518968 | Daniel Loper | Clinical Medical Laboratory | 3750 Moffett Rd, Mobile, AL 36618-1208 | 2019-09-26 |
| 1124676796 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 1845 Cherry St Fl 2, Montgomery, AL 36107-2613 | 2019-08-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.