Healthcare Provider Details

I. General information

NPI: 1184070971
Provider Name (Legal Business Name): HOOVER HOMETOWN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 JOHN HAWKINS PKWY STE 101A
HOOVER AL
35244-4021
US

IV. Provider business mailing address

2801 JOHN HAWKINS PKWY STE 101A
HOOVER AL
35244-4021
US

V. Phone/Fax

Practice location:
  • Phone: 205-650-1960
  • Fax: 205-490-6040
Mailing address:
  • Phone: 205-650-1960
  • Fax: 205-490-6040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number114622
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY COWART
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 256-516-2082