Organization
HOMETOWN MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY J CRAWFORD (CEO)
(859) 441-8876
Entity
Organization
Contact information
Practice address
814 BELMONT STREET, VICKSBURG, MS 39180
(601) 634-6363
(601) 634-6380
Mailing address
1019 TOWN DR, HIGHLAND HEIGHTS, KY 41076-9114
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440965
—
MS
Enumeration date
09/15/2006
Last updated
07/22/2022
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