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NPI Code Detail

MEDICARE: KRISTIN LEANN HORTON RPH

MEDICARE: KRISTIN LEANN HORTON RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist8085OR

General Provider Information

NPI Number : 1093008807
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN LEANN HORTON RPH
Provider Business Mailing Address
First Line : 1430 NW GARDEN VALLEY BLVD
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1766
Country : US
Telephone Number : 541-673-1750
Fax Number :
Provider Business Practice Location Address
First Line : 1430 NW GARDEN VALLEY BLVD
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1766
Country : US
Telephone Number : 541-673-1750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2011
Last Update Date : 05/26/2011

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