Healthcare Provider Details

I. General information

NPI: 1346285046
Provider Name (Legal Business Name): HORNES ARDERY DRUG STORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 MAIN ST
PARIS KY
40361-1817
US

IV. Provider business mailing address

630 MAIN ST
PARIS KY
40361-1817
US

V. Phone/Fax

Practice location:
  • Phone: 859-987-4181
  • Fax: 859-987-1930
Mailing address:
  • Phone: 859-987-4181
  • Fax: 859-987-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP02070
License Number StateKY

VIII. Authorized Official

Name: MR. MICHAEL D HORNE
Title or Position: PHARMACIST
Credential: RPH
Phone: 859-987-4181