Provider Demographics
NPI:1043698582
Name:HOMETOWN MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:HOMETOWN MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-441-1645
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-0707
Mailing Address - Country:US
Mailing Address - Phone:740-441-1645
Mailing Address - Fax:740-441-1648
Practice Address - Street 1:912 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2842
Practice Address - Country:US
Practice Address - Phone:740-775-2021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMETOWN MEDICAL SUPPLIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMER23298-ACHC332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment