Provider Demographics
NPI:1942051842
Name:HOMETOWN FAMILY MEDICINE AND URGENT CARE
Entity Type:Organization
Organization Name:HOMETOWN FAMILY MEDICINE AND URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLIWAY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:810-569-9514
Mailing Address - Street 1:6232 ATLAS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7804
Mailing Address - Country:US
Mailing Address - Phone:810-569-9514
Mailing Address - Fax:
Practice Address - Street 1:2462 E HILL RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5427
Practice Address - Country:US
Practice Address - Phone:810-569-9514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care