Provider Demographics
NPI:1104271220
Name:HORN, AUSTIN P (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:P
Last Name:HORN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:111 PIUTE DR.
Mailing Address - City:KERNVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93238-0097
Mailing Address - Country:US
Mailing Address - Phone:760-376-2216
Mailing Address - Fax:760-376-3858
Practice Address - Street 1:111 PIUTE DR.
Practice Address - Street 2:
Practice Address - City:KERNVILLE
Practice Address - State:CA
Practice Address - Zip Code:93238-0097
Practice Address - Country:US
Practice Address - Phone:760-376-2216
Practice Address - Fax:760-376-3858
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH51297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist