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NPI Code Detail

MEDICARE: KELLY D HORTON RPH

MEDICARE:   KELLY D 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
1183500000XPharmacistPD07722AR
2183500000XPharmacist56429TX

General Provider Information

NPI Number : 1316313513
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY D HORTON RPH
Provider Business Mailing Address
First Line : 1517 FRONTAGE RD
Second Line :
City : LONOKE
State : AR
Zip : 72086-9200
Country : US
Telephone Number : 501-251-7421
Fax Number :
Provider Business Practice Location Address
First Line : 2404 S PROMENADE BLVD
Second Line :
City : ROGERS
State : AR
Zip : 72758-9080
Country : US
Telephone Number : 479-986-1101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2015
Last Update Date : 08/11/2015

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Directions to “ KELLY D HORTON RPH” Practice Location

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