Provider Demographics
NPI:1538330972
Name:LINDSEYS HOMETOWN PHARMACY LLC
Entity Type:Organization
Organization Name:LINDSEYS HOMETOWN PHARMACY LLC
Other - Org Name:HOMETOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:229-686-9339
Mailing Address - Street 1:407 E MCPHERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-2267
Mailing Address - Country:US
Mailing Address - Phone:229-686-9339
Mailing Address - Fax:229-686-7888
Practice Address - Street 1:407 E MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2267
Practice Address - Country:US
Practice Address - Phone:229-686-9339
Practice Address - Fax:229-686-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BX2000X, 333600000X, 3336L0003X
GAPHRE0094533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA236358774AMedicaid
2017404OtherPK
GA236358774BMedicaid
GA236358774BMedicaid