Provider Demographics
NPI:1184011520
Name:HORAN LLC
Entity Type:Organization
Organization Name:HORAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-503-6158
Mailing Address - Street 1:1401 S, BRENTWOOD BLVD
Mailing Address - Street 2:STE. 835
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144
Mailing Address - Country:US
Mailing Address - Phone:314-503-6158
Mailing Address - Fax:
Practice Address - Street 1:1401 S BRENTWOOD BLVD
Practice Address - Street 2:STE. 835
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1416
Practice Address - Country:US
Practice Address - Phone:314-503-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9455146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty