Organization
HOMETOWN PHARMACY OF MEDINA LLC
Active
Organization
HOMETOWN PHARMACY OF MEDINA LLC
Active
Other names
Medina Main Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA ROBBINS DPH (PHARMACIST AND OWNER)
(731) 783-0777
Entity
Organization
Contact information
Practice address
107 S MAIN ST, MEDINA, TN 38355-9702
(731) 783-0777
(731) 783-3005
Mailing address
PO BOX 310, MEDINA, TN 38355-0310
(731) 783-0777
(731) 783-3005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4079
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4437693
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/09/2007
Last updated
04/02/2014
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