Provider Demographics
NPI:1033477054
Name:HORVAT, MARY JO (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:MARY JO
Middle Name:
Last Name:HORVAT
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9032 AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6155
Mailing Address - Country:US
Mailing Address - Phone:724-625-0131
Mailing Address - Fax:
Practice Address - Street 1:1050 CRANBERRY SQUARE DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6142
Practice Address - Country:US
Practice Address - Phone:724-778-6305
Practice Address - Fax:724-778-6321
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034509R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist