Provider Demographics
NPI:1598486755
Name:HOMETOWN URGENT CARE AND FAMILY MEDICINE
Entity Type:Organization
Organization Name:HOMETOWN URGENT CARE AND FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:601-504-3424
Mailing Address - Street 1:10080 ROAD 539
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-8086
Mailing Address - Country:US
Mailing Address - Phone:601-504-3424
Mailing Address - Fax:
Practice Address - Street 1:209 MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-2521
Practice Address - Country:US
Practice Address - Phone:601-504-3424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care