Organization
HOMETOWN DEVELOPMENT
Active
Other names
Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SANDALL (CO-OWNER)
(308) 882-4863
Entity
Organization
Contact information
Practice address
1324 BROADWAY, IMPERIAL, NE 69033-0597
(308) 882-4863
(308) 882-4510
Mailing address
1324 BROADWAY; PO BOX 597, IMPERIAL, NE 69033-0597
(308) 882-4863
(308) 882-4510
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2686
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025337400
—
NE
Enumeration date
09/20/2006
Last updated
08/22/2020
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