MEDICARE: HOOVER HOMETOWN PHARMACY

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	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	114622	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2159877	OTHER		PK

General Provider Information

NPI Number	:	1184070971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOOVER HOMETOWN PHARMACY

Provider Business Mailing Address
First Line	:	2801 JOHN HAWKINS PKWY STE 101A
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4021
Country	:	US
Telephone Number	:	205-650-1960
Fax Number	:	205-490-6040

Provider Business Practice Location Address
First Line	:	2801 JOHN HAWKINS PKWY STE 101A
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4021
Country	:	US
Telephone Number	:	205-650-1960
Fax Number	:	205-490-6040

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	WHITNEY COWART
Credential	:
Telephone Number	:	256-516-2082

Provider Enumeration Date	:	05/11/2016
Last Update Date	:	11/05/2019

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Directions to “HOOVER HOMETOWN PHARMACY ” Practice Location

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