MEDICARE: HORIZON PACE, LLC

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
1	251T00000X	PACE Provider Organization

General Provider Information

NPI Number	:	1093457830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON PACE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 572
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40476-0572
Country	:	US
Telephone Number	:	859-623-4080
Fax Number	:	859-624-5771

Provider Business Practice Location Address
First Line	:	2028 MERRICK DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-8133
Country	:	US
Telephone Number	:	859-623-4080
Fax Number	:	859-624-5771

Authorized Official
Title or Position	:	OPERATIONS ASSOCIATE
Name	:	MARIBETH UPCHURCH
Credential	:
Telephone Number	:	859-623-4080

Provider Enumeration Date	:	04/12/2022
Last Update Date	:	04/13/2022

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Directions to “HORIZON PACE, LLC ” Practice Location

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