Organization
HOMETOWN PHARMACY LLC
Active
Other names
Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VANCE OGLESBEEE (PRESIDENT)
(903) 872-3873
Entity
Organization
Contact information
Practice address
2800 W HIGHWAY 22, CORSICANA, TX 75110-2454
(903) 872-3784
(903) 872-3791
Mailing address
2800 W HIGHWAY 22, CORSICANA, TX 75110-2454
(903) 872-3784
(903) 872-3791
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27531
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130714
PK
—
Enumeration date
06/24/2011
Last updated
07/02/2013
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