Healthcare Provider Details

I. General information

NPI: 1174637797
Provider Name (Legal Business Name): JULIAN BOURNE HORST PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIAN HELENA BOURNE PHARM.D.

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD DEPARTMENT OF PHARMACY
COLUMBIA SC
29209-1638
US

IV. Provider business mailing address

1 CASTLE HALL CT
COLUMBIA SC
29209-0807
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-4000
  • Fax:
Mailing address:
  • Phone: 803-738-0629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6403
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number6403
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: