Healthcare Provider Details

I. General information

NPI: 1982923215
Provider Name (Legal Business Name): BRIDGET DENISE HORTON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 MONO WAY SAV MART PHARMACY
SONORA CA
95370-5282
US

IV. Provider business mailing address

1032 SANDALWOOD DR P O BOX 2667
MURPHYS CA
95247-9664
US

V. Phone/Fax

Practice location:
  • Phone: 209-536-1118
  • Fax: 209-536-9079
Mailing address:
  • Phone: 209-728-9180
  • Fax: 209-728-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: