Provider Demographics
NPI:1255851465
Name:HOMETOWN HEALTHCARE LLC
Entity type:Organization
Organization Name:HOMETOWN HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:830-879-2279
Mailing Address - Street 1:PO BOX 2070
Mailing Address - Street 2:
Mailing Address - City:ORANGE GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:78372-2070
Mailing Address - Country:US
Mailing Address - Phone:830-879-2279
Mailing Address - Fax:830-879-2235
Practice Address - Street 1:101 S EUGENIA ST
Practice Address - Street 2:
Practice Address - City:ORANGE GROVE
Practice Address - State:TX
Practice Address - Zip Code:78372
Practice Address - Country:US
Practice Address - Phone:830-879-2279
Practice Address - Fax:830-879-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty