MEDICARE: HOMETOWN EYE CARE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1104792159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN EYE CARE PA

Provider Business Mailing Address
First Line	:	109 15TH AVE E
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308-2509
Country	:	US
Telephone Number	:	320-762-5112
Fax Number	:	320-763-3297

Provider Business Practice Location Address
First Line	:	109 15TH AVE E
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308-2509
Country	:	US
Telephone Number	:	320-762-5112
Fax Number	:	320-763-3297

Authorized Official
Title or Position	:	INSURANCE ELIGIBILITY
Name	:	JULIE FROVARP
Credential	:
Telephone Number	:	320-762-5112

Provider Enumeration Date	:	10/16/2025
Last Update Date	:	02/24/2026

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