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Organization
HOMETOWN LONG TERM CARE PHARMACY LLC
Active
Organization
HOMETOWN LONG TERM CARE PHARMACY LLC
Active
Other names
Hometown Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE DEANS (CONTRACTING SPECIALIST)
(920) 992-6800
Entity
Organization
Contact information
Practice address
1571 IVORY DR, SUN PRAIRIE, WI 53590-1820
(608) 846-2750
(608) 846-2751
Mailing address
333 LOWVILLE RD, RIO, WI 53960-9437
(920) 992-6800
(920) 992-6801
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
9427-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137457
PK
—
Enumeration date
06/21/2012
Last updated
09/19/2025
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