Provider Demographics
NPI:1629537212
Name:HOMETOWN PHARMACY OF FRANKFORT EAST , PLLC
Entity Type:Organization
Organization Name:HOMETOWN PHARMACY OF FRANKFORT EAST , PLLC
Other - Org Name:HOMETOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER , RPH
Authorized Official - Prefix:
Authorized Official - First Name:BIJALKUMAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-699-2690
Mailing Address - Street 1:190 VERSAILLES RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-3272
Mailing Address - Country:US
Mailing Address - Phone:502-699-2690
Mailing Address - Fax:502-699-2694
Practice Address - Street 1:190 VERSAILLES RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3272
Practice Address - Country:US
Practice Address - Phone:859-940-2950
Practice Address - Fax:502-699-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP08047OtherPHARMACY PERMIT