Provider Demographics
NPI:1609312503
Name:HORNSHUH, DAVID L (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:HORNSHUH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:L
Other - Last Name:HORNSHUH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:9604 HEATHERMILL LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8577
Mailing Address - Country:US
Mailing Address - Phone:919-720-1681
Mailing Address - Fax:
Practice Address - Street 1:9604 HEATHERMILL LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8577
Practice Address - Country:US
Practice Address - Phone:919-720-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH-28365183500000X
ORRPH-0005832183500000X
HIPH-482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist