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Organization

HOMETOWN HEALTHCARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS WAYNE HAGINS (OWNER)
(229) 924-4156
Entity
Organization

Contact information

Practice address
1035 E FORSYTH ST, AMERICUS, GA 31709-3721
(229) 924-5200
(229) 924-0073
Mailing address
1035 E FORSYTH ST, AMERICUS, GA 31709-3721
(229) 924-5200
(229) 924-0073

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
118093
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
285996480D
GA
Enumeration date
02/04/2012
Last updated
04/19/2018
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