Provider Demographics
NPI:1699974758
Name:HORN, DEBRA (PHARM D)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:HORN
Suffix:
Gender:F
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 1:221 PINECREST CIR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-7935
Mailing Address - Country:US
Mailing Address - Phone:843-706-2192
Mailing Address - Fax:
Practice Address - Street 1:221 PINECREST CIR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-7935
Practice Address - Country:US
Practice Address - Phone:843-706-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011144183500000X
SC11389183500000X
GA23044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist