Provider Demographics
NPI:1093940322
Name:HOMEWOOD PHARMACY
Entity Type:Organization
Organization Name:HOMEWOOD PHARMACY
Other - Org Name:HOMEWOOD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC/AO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-871-9000
Mailing Address - Street 1:940 OXMOOR RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5228
Mailing Address - Country:US
Mailing Address - Phone:205-871-9000
Mailing Address - Fax:205-871-9040
Practice Address - Street 1:940 OXMOOR RD
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-5228
Practice Address - Country:US
Practice Address - Phone:205-871-9000
Practice Address - Fax:205-871-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 333600000X
AL1132583336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1093940322Medicaid
2120248OtherPK