Provider Demographics
NPI:1063466266
Name:NEW HORIZON PHARMACY, INC,
Entity Type:Organization
Organization Name:NEW HORIZON PHARMACY, INC,
Other - Org Name:NEW HORIZON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:PRESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:904-398-2881
Mailing Address - Street 1:3606-2 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5641
Mailing Address - Country:US
Mailing Address - Phone:904-398-2881
Mailing Address - Fax:904-398-2882
Practice Address - Street 1:3606-2 EMERSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5641
Practice Address - Country:US
Practice Address - Phone:904-398-2881
Practice Address - Fax:904-398-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH215913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5593130001Medicare ID - Type Unspecified