Provider Demographics
NPI:1780954230
Name:VAN HORN, HOWARD FOARD III (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:FOARD
Last Name:VAN HORN
Suffix:III
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43281 TUMBLETREE TER
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4590
Mailing Address - Country:US
Mailing Address - Phone:703-726-9681
Mailing Address - Fax:
Practice Address - Street 1:20321 SUSAN LESLIE DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5682
Practice Address - Country:US
Practice Address - Phone:703-726-8647
Practice Address - Fax:703-729-7240
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist