Provider Demographics
NPI:1275825911
Name:HOMETOWN MEDICAL LLC
Entity Type:Organization
Organization Name:HOMETOWN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-395-2399
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:SMITHERS
Mailing Address - State:WV
Mailing Address - Zip Code:25186-0011
Mailing Address - Country:US
Mailing Address - Phone:304-395-2399
Mailing Address - Fax:
Practice Address - Street 1:190 MICHIGAN AVE.
Practice Address - Street 2:
Practice Address - City:SMITHERS
Practice Address - State:WV
Practice Address - Zip Code:25186-0011
Practice Address - Country:US
Practice Address - Phone:304-442-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22515890332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies