Provider Demographics
NPI:1073681193
Name:HORN, DAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:
Last Name:HORN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 BRUNSWICK CIR SE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON COVE
Mailing Address - State:AL
Mailing Address - Zip Code:35763-8451
Mailing Address - Country:US
Mailing Address - Phone:256-539-1412
Mailing Address - Fax:
Practice Address - Street 1:6727 HIGHWAY 431 S
Practice Address - Street 2:SUITE M
Practice Address - City:HAMPTON COVE
Practice Address - State:AL
Practice Address - Zip Code:35763-9225
Practice Address - Country:US
Practice Address - Phone:256-425-0054
Practice Address - Fax:256-425-0057
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist