Organization
MCKPS 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
581 MAIN ST N, MC KEE, KY 40447-9082
(606) 287-4719
(606) 287-7822
Mailing address
581 MAIN ST N, MC KEE, KY 40447-9082
(606) 287-4719
(606) 287-7822
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
P07434
KY
3336C0003X
Community/Retail Pharmacy
Primary
P07809
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128345
PK
—
Enumeration date
01/13/2011
Last updated
03/15/2017
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