Provider Demographics
NPI:1043900160
Name:HOMETOWN PHARMACY OF SPRINGFIELD, PLLC
Entity Type:Organization
Organization Name:HOMETOWN PHARMACY OF SPRINGFIELD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELEIGHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:270-789-4663
Mailing Address - Street 1:100 W DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-1190
Mailing Address - Country:US
Mailing Address - Phone:859-217-5050
Mailing Address - Fax:859-217-5051
Practice Address - Street 1:100 W DEPOT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069-1190
Practice Address - Country:US
Practice Address - Phone:859-217-5050
Practice Address - Fax:859-217-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy