Provider Demographics
NPI:1629377338
Name:HORSLEY, WILLIAM PERRY JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PERRY
Last Name:HORSLEY
Suffix:JR
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:PO BOX 1817
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-1817
Mailing Address - Country:US
Mailing Address - Phone:804-693-2160
Mailing Address - Fax:804-694-4418
Practice Address - Street 1:6908 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-5121
Practice Address - Country:US
Practice Address - Phone:804-693-2160
Practice Address - Fax:804-694-4418
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist