Provider Demographics
NPI:1619657731
Name:HOMETOWN RX CORPORATION
Entity Type:Organization
Organization Name:HOMETOWN RX CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-710-2516
Mailing Address - Street 1:2940 YORKSHIP SQ
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08104-2857
Mailing Address - Country:US
Mailing Address - Phone:856-541-2990
Mailing Address - Fax:
Practice Address - Street 1:2940 YORKSHIP SQ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08104-2857
Practice Address - Country:US
Practice Address - Phone:856-541-2990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy