Organization
HOMETOWN PHARMACY LLC
Active
Other names
Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LISA SMITH (OWNER)
(434) 660-4421
Entity
Organization
Contact information
Practice address
196 AMELON SQ, MADISON HEIGHTS, VA 24572-5990
(434) 929-1000
(434) 929-1009
Mailing address
PO BOX 2408, APPOMATTOX, VA 24522-2408
(434) 929-1000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004758
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167627
PK
—
Enumeration date
02/27/2017
Last updated
03/22/2017
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