Organization
HOMETOWN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VANCE JACKSON OGLESBEE R.P.H. (CORPORATE MANAGER)
(903) 389-2541
Entity
Organization
Contact information
Practice address
201 E COMMERCE ST, FAIRFIELD, TX 75840-1509
(903) 389-2541
Mailing address
201 E COMMERCE ST, FAIRFIELD, TX 75840-1509
(903) 389-2541
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
4519647
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145177
—
TX
05
—
150464901
—
TX
01
—
4519647
NABP
TX
Enumeration date
09/01/2006
Last updated
04/05/2016
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