Provider Demographics
NPI:1992875025
Name:HORIZON HEALTHCARE MANAGEMENT
Entity type:Organization
Organization Name:HORIZON HEALTHCARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-228-5940
Mailing Address - Street 1:185 STAFFORD UMBERGER RD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-4439
Mailing Address - Country:US
Mailing Address - Phone:276-228-5940
Mailing Address - Fax:276-228-9292
Practice Address - Street 1:185 STAFFORD UMBERGER RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-4439
Practice Address - Country:US
Practice Address - Phone:276-228-5940
Practice Address - Fax:276-228-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201003165332BN1400X, 3336L0003X
TN0000013211332BN1400X, 3336L0003X
WVM00559211332BN1400X, 3336L0003X
NC08170332BN1400X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4827967OtherNCPDP
WV4827967OtherNCPDP
TN4827967OtherNCPDP
NC4810493Medicaid
VA4827967OtherNCPDP