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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