Organization
HOMETOWN UMATILLA LLC
Active
Other names
UMATILLA DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GREER RPH (OWNER)
(352) 669-1166
Entity
Organization
Contact information
Practice address
901 N CENTRAL AVE, UMATILLA, FL 32784-8655
(352) 669-1166
(354) 669-8866
Mailing address
901 N CENTRAL AVE, UMATILLA, FL 32784-8655
(352) 669-1166
(354) 669-8866
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH22141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007030
PK
—
Enumeration date
08/02/2006
Last updated
02/20/2017
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