Provider Demographics
NPI:1982923215
Name:HORTON, BRIDGET DENISE (RPH)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:DENISE
Last Name:HORTON
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 1:1032 SANDALWOOD DR
Mailing Address - Street 2:P O BOX 2667
Mailing Address - City:MURPHYS
Mailing Address - State:CA
Mailing Address - Zip Code:95247-9664
Mailing Address - Country:US
Mailing Address - Phone:209-728-9180
Mailing Address - Fax:209-728-9071
Practice Address - Street 1:1045 MONO WAY
Practice Address - Street 2:SAV MART PHARMACY
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5282
Practice Address - Country:US
Practice Address - Phone:209-536-1118
Practice Address - Fax:209-536-9079
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA32311OtherCALIFORNIA STATE BOARD OF PHARMACY