Organization
WCPS LLC
Active
Other names
Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW HUTERA (OWNER)
(651) 214-3762
Entity
Organization
Contact information
Practice address
66 CENTER AVE, WHITLEY CITY, KY 42653
(606) 376-3300
(606) 376-3330
Mailing address
PO BOX 517, WHITLEY CITY, KY 42653-0517
(606) 376-3300
(606) 376-3330
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
P07542
KY
3336C0003X
Community/Retail Pharmacy
Primary
P07808
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132657
PK
—
05
—
7100231780
—
KY
Enumeration date
11/14/2011
Last updated
03/15/2017
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