Provider Demographics
NPI:1366689622
Name:HORIZON PHARMACY LLC
Entity Type:Organization
Organization Name:HORIZON PHARMACY LLC
Other - Org Name:BIOMED PHARMACY-LAKE LANSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-371-3300
Mailing Address - Street 1:1515 LAKE LANSING RD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3753
Mailing Address - Country:US
Mailing Address - Phone:517-371-3300
Mailing Address - Fax:517-371-3353
Practice Address - Street 1:1515 LAKE LANSING RD
Practice Address - Street 2:SUITE B2
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3753
Practice Address - Country:US
Practice Address - Phone:517-371-3300
Practice Address - Fax:517-371-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010090233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118451OtherPK
MI1366689622Medicaid