Organization
MANPS 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
397 OLD US HIGHWAY 421, MANCHESTER, KY 40962-7538
(606) 598-6337
(606) 598-6339
Mailing address
397 OLD US HIGHWAY 421, MANCHESTER, KY 40962-7538
(606) 598-6337
(606) 598-6339
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07807
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165920
PK
—
Enumeration date
07/10/2009
Last updated
07/12/2017
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