Organization
YOUR HOMETOWN PHARMACY INC
Active
Other names
Core LTC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KODY HALL (CEO/OWNER)
(402) 991-7283
Entity
Organization
Contact information
Practice address
7428 EASTPORT PKWY STE 101, LA VISTA, NE 68128-2348
(402) 991-7283
(402) 991-7281
Mailing address
7428 EASTPORT PKWY STE 1, LA VISTA, NE 68128-2346
(402) 991-7283
(402) 991-7281
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
2927
NE
3336L0003X
Long Term Care Pharmacy
Primary
4190
IA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025962200
—
NE
01
—
2129273
PK
—
Enumeration date
03/11/2011
Last updated
03/03/2025
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