Healthcare Provider Details

I. General information

NPI: 1629377338
Provider Name (Legal Business Name): WILLIAM PERRY HORSLEY JR. RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6908 MAIN ST
GLOUCESTER VA
23061-5121
US

IV. Provider business mailing address

PO BOX 1817
GLOUCESTER VA
23061-1817
US

V. Phone/Fax

Practice location:
  • Phone: 804-693-2160
  • Fax: 804-694-4418
Mailing address:
  • Phone: 804-693-2160
  • Fax: 804-694-4418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202004971
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: