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General NPI Number Information
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NPI Number | 1285813188
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Entity Type | Organization
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Legal Business Name | HORUS MEDICAL
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 4217 CASWELL RD
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City | JOHNSTOWN
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State | OH
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Zip | 43031-9592
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Country | US
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Telephone | 614-402-5321
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Fax | 740-967-4455
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Provider Business Mailing Address
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Address Line | 4217 CASWELL RD
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City | JOHNSTOWN
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State | OH
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Zip | 43031-9592
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Country | US
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Telephone | 614-402-5321
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Fax | 740-967-4455
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL KEYS HENDERSHOT
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Credential |
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Telephone | 614-402-5325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 282987
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 282987
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License Number State | OH
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