MEDICARE: DR. LORI BUSSEY HORNSBY PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	020336	GA

General Provider Information

NPI Number	:	1649274242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI BUSSEY HORNSBY PHARMD

Provider Business Mailing Address
First Line	:	1311 GRIST MILL DR
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-1329
Country	:	US
Telephone Number	:	334-297-0443
Fax Number	:	706-571-1781

Provider Business Practice Location Address
First Line	:	1800 10TH AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-3624
Country	:	US
Telephone Number	:	706-320-8696
Fax Number	:	706-571-1781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/08/2007

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