Organization
HOMETOWN MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE CAROTHERS (OWNER)
(870) 265-4100
Entity
Organization
Contact information
Practice address
321 MAIN ST, LAKE VILLAGE, AR 71653-1941
(870) 265-4100
(870) 265-6047
Mailing address
PO BOX 329, LAKE VILLAGE, AR 71653-0329
(870) 265-4100
(870) 265-6047
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135374716
—
AR
01
—
49507
BCBS
AR
Enumeration date
03/20/2007
Last updated
01/25/2023
Update your record
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