Provider Demographics
NPI:1841744604
Name:HORAN, KERRY JOSEPH (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:JOSEPH
Last Name:HORAN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CRESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:285 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-2029
Practice Address - Country:US
Practice Address - Phone:603-298-9680
Practice Address - Fax:866-301-3489
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2017-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist