MEDICARE: HOMETOWN MEDICAL EQUIPMENT INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	011145	AL

General Provider Information

NPI Number	:	1477515005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN MEDICAL EQUIPMENT INC

Provider Business Mailing Address
First Line	:	PO BOX 1127
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037-1127
Country	:	US
Telephone Number	:	334-382-0860
Fax Number	:	334-382-0862

Provider Business Practice Location Address
First Line	:	1119 E COMMERCE ST
Second Line	:
City	:	GREENVILLE
State	:	AL
Zip	:	36037-2113
Country	:	US
Telephone Number	:	334-382-0860
Fax Number	:	334-382-0862

Authorized Official
Title or Position	:	OWNER
Name	:	JACKIE J POWELL
Credential	:
Telephone Number	:	334-382-0860

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	10/26/2007

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