Provider Demographics
NPI:1700262375
Name:HORN, LACEY HEWITT (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:LACEY
Middle Name:HEWITT
Last Name:HORN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:LACEY
Other - Middle Name:JANE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:HARPS PHARMACY, 1780 N. CROSSOVER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-571-1214
Mailing Address - Fax:479-571-2552
Practice Address - Street 1:HARPS PHARMACY, 1780 N. CROSSOVER RD
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-571-1214
Practice Address - Fax:479-571-2552
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist