Provider Demographics
NPI:1255428447
Name:HORTON BROTHERS AND BROWN LLC
Entity type:Organization
Organization Name:HORTON BROTHERS AND BROWN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-474-5655
Mailing Address - Street 1:201 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-1303
Mailing Address - Country:US
Mailing Address - Phone:606-474-5655
Mailing Address - Fax:606-474-8866
Practice Address - Street 1:201 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1303
Practice Address - Country:US
Practice Address - Phone:606-474-5655
Practice Address - Fax:606-474-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
KYP077683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2028685OtherPK
1804930OtherNCPDP PROVIDER IDENTIFICATION NUMBER
KY6444150001Medicare NSC