Provider Demographics
NPI:1831325257
Name:HORACE, ALEXIS E (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:E
Last Name:HORACE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 HAMMOND PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3179
Mailing Address - Country:US
Mailing Address - Phone:901-826-1508
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH STREET, BI-2101
Practice Address - Street 2:MEDICAL COLLEGE OF GEORGIA (MCG) HEALTH SYSTEM
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:706-721-4519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024717183500000X
TN33399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist