Healthcare Provider Details

I. General information

NPI: 1245328087
Provider Name (Legal Business Name): HORIZON HOME RESPIRATORY AND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 S BICKETT BLVD
LOUISBURG NC
27549-2672
US

IV. Provider business mailing address

133 S BICKETT BLVD
LOUISBURG NC
27549-2672
US

V. Phone/Fax

Practice location:
  • Phone: 919-496-7362
  • Fax: 919-496-6379
Mailing address:
  • Phone: 919-496-7362
  • Fax: 919-496-6379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. TIMOTHY CLIFTON MUSTIAN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 919-496-7362