Provider Demographics
NPI:1225202765
Name:HOMETOWN MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:HOMETOWN MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHY
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,ACNP
Authorized Official - Phone:901-476-9996
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:TN
Mailing Address - Zip Code:38049-0305
Mailing Address - Country:US
Mailing Address - Phone:901-476-9996
Mailing Address - Fax:901-476-9986
Practice Address - Street 1:635 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-2427
Practice Address - Country:US
Practice Address - Phone:901-476-9996
Practice Address - Fax:901-476-9986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3404436Medicaid
TN3404436Medicare PIN