Provider Demographics
NPI:1356343776
Name:BORNHORST, DANA K (RPH)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:K
Last Name:BORNHORST
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 EASTMOOR CT
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-1101
Mailing Address - Country:US
Mailing Address - Phone:419-629-0917
Mailing Address - Fax:
Practice Address - Street 1:324 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-9560
Practice Address - Country:US
Practice Address - Phone:419-628-2305
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-23967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist