# BENNETT'S HOMETOWN PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902963648
- **Authorized official:** MS. DENISE B BENNETT R.PH. (OWNER)
- **Authorized official phone:** (912) 462-3784

## Contact information

- **Practice address:** 13202 CLEVELAND ST W STE 100, NAHUNTA, GA 31553-2842
- **Practice address phone:** (912) 462-3784
- **Practice address fax:** (912) 462-8040
- **Mailing address:** 13202 CLEVELAND ST W STE 100, NAHUNTA, GA 31553-2842
- **Mailing address phone:** (912) 462-3784
- **Mailing address fax:** (912) 462-8040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE008878 | GA | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 05/12/2009