Provider Demographics
NPI:1376201186
Name:HORIZON PHARMACY
Entity Type:Organization
Organization Name:HORIZON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-588-9337
Mailing Address - Street 1:PO BOX 1246
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1246
Mailing Address - Country:US
Mailing Address - Phone:787-824-9933
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 706 KM. 7.1
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-824-9933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON MEDICAL HEALTH GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRCERTIFICATEOther474584