Organization
HOMETOWN DRUG COMPANY LLC
Active
Other names
Hometown Drug Company, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CARTER PHARMD (CEO, OWNER)
(405) 388-4822
Entity
Organization
Contact information
Practice address
307 N BROADWAY ST, POTEAU, OK 74953-3355
(918) 647-2349
(918) 647-2359
Mailing address
PO BOX 459, POTEAU, OK 74953-0459
(918) 647-2349
(918) 647-2359
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
195660
OK
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200347280B
—
OK
05
—
200347280C
—
OK
01
—
2129724
PK
—
Enumeration date
04/05/2011
Last updated
02/20/2017
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