Healthcare Provider Details

I. General information

NPI: 1366689622
Provider Name (Legal Business Name): HORIZON PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 LAKE LANSING RD SUITE B2
LANSING MI
48912-3753
US

IV. Provider business mailing address

1515 LAKE LANSING RD SUITE B2
LANSING MI
48912-3753
US

V. Phone/Fax

Practice location:
  • Phone: 517-371-3300
  • Fax: 517-371-3353
Mailing address:
  • Phone: 517-371-3300
  • Fax: 517-371-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009023
License Number StateMI

VIII. Authorized Official

Name: MICHELLE STURGEON
Title or Position: PHARMACIST
Credential:
Phone: 513-371-3300