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NPI Code Detail

MEDICARE: HOMETOWN HEALTHCARE LLC

MEDICARE: HOMETOWN HEALTHCARE LLC
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
1261QR1300XRural Health Clinic/CenterPA04256TX

General Provider Information

NPI Number : 1881911030
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOMETOWN HEALTHCARE LLC
Provider Business Mailing Address
First Line : PO BOX 2070
Second Line :
City : ORANGE GROVE
State : TX
Zip : 78372-2070
Country : US
Telephone Number : 830-879-2279
Fax Number : 830-879-2235
Provider Business Practice Location Address
First Line : 408 N GIRAUD
Second Line :
City : COTULLA
State : TX
Zip : 78014-3113
Country : US
Telephone Number : 830-879-2279
Fax Number : 830-879-2235
Authorized Official
Title or Position : PRESIDENT
Name : MR. WILL D THOMPSON
Credential : PA-C
Telephone Number : 830-879-2279
Provider Enumeration Date : 04/28/2010
Last Update Date : 02/20/2017

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Directions to “HOMETOWN HEALTHCARE LLC ” Practice Location

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