Provider Demographics
NPI:1326630005
Name:HOMETOWN PHARMACY LLC
Entity Type:Organization
Organization Name:HOMETOWN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-319-7946
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MS
Mailing Address - Zip Code:39746-0155
Mailing Address - Country:US
Mailing Address - Phone:662-362-7070
Mailing Address - Fax:662-362-7249
Practice Address - Street 1:40518 OLD HIGHWAY 45 S
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MS
Practice Address - Zip Code:39746-9799
Practice Address - Country:US
Practice Address - Phone:662-362-7070
Practice Address - Fax:662-362-7249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy