Provider Demographics
NPI:1770579302
Name:HOMETOWN MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:HOMETOWN MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-441-1645
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-0707
Mailing Address - Country:US
Mailing Address - Phone:740-441-1645
Mailing Address - Fax:740-441-1648
Practice Address - Street 1:683 STATE ROUTE 7 N
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-5920
Practice Address - Country:US
Practice Address - Phone:740-441-1645
Practice Address - Fax:740-441-1648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5404110003332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5404110003Medicare ID - Type Unspecified
OH5404110002Medicare ID - Type Unspecified
OH5404110001Medicare ID - Type Unspecified