Provider Demographics
NPI:1376324277
Name:HOMETOWN LACTATION, L.L.C.
Entity Type:Organization
Organization Name:HOMETOWN LACTATION, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:RHIANNON
Authorized Official - Last Name:KESTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN, IBCLC
Authorized Official - Phone:812-240-8797
Mailing Address - Street 1:2015 BRASSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7500
Mailing Address - Country:US
Mailing Address - Phone:812-240-8797
Mailing Address - Fax:855-975-2722
Practice Address - Street 1:124 S KEENELAND DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3279
Practice Address - Country:US
Practice Address - Phone:812-240-8797
Practice Address - Fax:855-975-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service