Provider Demographics
NPI:1700557063
Name:HOMETOWN HEALTHCARE PLLC
Entity Type:Organization
Organization Name:HOMETOWN HEALTHCARE PLLC
Other - Org Name:HOMETOWN HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:TURNER
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-452-0228
Mailing Address - Street 1:272 COUNTY HIGHWAY 57
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-4416
Mailing Address - Country:US
Mailing Address - Phone:256-452-0228
Mailing Address - Fax:
Practice Address - Street 1:103 4TH ST N
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-1424
Practice Address - Country:US
Practice Address - Phone:205-274-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-25
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447746433OtherNPI