# HOMETOWN MEDICAL SUPPLIES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hometown Medical Supplies, Reliable Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750040465
- **Authorized official:** KILEY ANN RUSSELL (SENIOR DIRECTOR OF PAYOR RELATIONS)
- **Authorized official phone:** (629) 252-8211

## Contact information

- **Practice address:** 4873 WEST LN STE C, STOCKTON, CA 95210-4548
- **Practice address phone:** (209) 472-1136
- **Practice address fax:** (209) 472-1138
- **Mailing address:** 9495 WINNETKA AVE N STE 200, BROOKLYN PARK, MN 55445-1618
- **Mailing address phone:** (292) 528-2116
- **Mailing address fax:** (763) 255-3972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 12/09/2021
- **Last updated:** 06/04/2026