Provider Demographics
NPI:1851451314
Name:ASHLAND HOME TOWNE PHARMACY INC
Entity Type:Organization
Organization Name:ASHLAND HOME TOWNE PHARMACY INC
Other - Org Name:TOWNE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MAIYER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:419-281-4040
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:849 SMITH ROAD
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-0328
Mailing Address - Country:US
Mailing Address - Phone:419-281-4040
Mailing Address - Fax:
Practice Address - Street 1:849 SMITH RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3644
Practice Address - Country:US
Practice Address - Phone:419-281-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMEL 11084332B00000X, 332BC3200X, 332BN1400X, 332BP3500X, 332BX2000X
OH02-0112600333600000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02-0112600OtherSTATE PHARMACY LICENSE
OH3214506Medicaid
3616034OtherNABP NUMBER
3616034OtherNABP NUMBER
0214930001Medicare NSC