Organization
HOMETOWN LONG TERM CARE PHARMACY LLC
Active
Other names
Hometown Long Term Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE DEANS (CONTRACTING SPECIALIST)
(920) 992-6800
Entity
Organization
Contact information
Practice address
1571 IVORY DR, SUN PRAIRIE, WI 53590-1820
(608) 846-2750
(608) 846-2751
Mailing address
333 LOWVILLE RD, RIO, WI 53960-9437
(920) 992-6800
(920) 992-6801
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
9427-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137457
PK
—
Enumeration date
06/21/2012
Last updated
09/19/2025
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