MEDICARE: MR. THOMAS D. HORNE PHARM D.

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	183500000X	Pharmacist	6286	MT

General Provider Information

NPI Number	:	1114222734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS D. HORNE PHARM D.

Provider Business Mailing Address
First Line	:	202 WEST GARNET WAY
Second Line	:
City	:	WARM SPRINGS
State	:	MT
Zip	:	59756-0300
Country	:	US
Telephone Number	:	406-693-7179
Fax Number	:	406-693-7181

Provider Business Practice Location Address
First Line	:	202 WEST GARNET WAY
Second Line	:
City	:	WARM SPRINGS
State	:	MT
Zip	:	59756-0300
Country	:	US
Telephone Number	:	406-693-7179
Fax Number	:	406-693-7181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	01/12/2011

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