Organization
P R HORTON RPH INC
Active
Other names
Continue Care Home Infusion
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL R HORTON RP (PRESIDENT)
(712) 224-2845
Entity
Organization
Contact information
Practice address
2609 APACHE CT, SIOUX CITY, IA 51104-1504
(712) 224-2845
(712) 224-2846
Mailing address
2609 APACHE CT, SIOUX CITY, IA 51104-1504
(712) 224-2845
(712) 224-2846
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
59
IA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
59
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0208330
—
IA
01
—
20136
WELLMARK BLUE CROSS BLUE SHIELD OF IOWA
IA
05
—
9167250
—
SD
05
—
XXXXXXXXX00
—
NE
Enumeration date
05/02/2008
Last updated
05/02/2008
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