Healthcare Provider Details

I. General information

NPI: 1295372068
Provider Name (Legal Business Name): HOMETOWN PHARMACY OF LEXINGTON,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2019
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 RICHMOND RD STE 190
LEXINGTON KY
40509-2766
US

IV. Provider business mailing address

2860 RICHMOND RD STE 190
LEXINGTON KY
40509-2766
US

V. Phone/Fax

Practice location:
  • Phone: 859-407-4135
  • Fax: 859-407-4133
Mailing address:
  • Phone: 859-407-4135
  • Fax: 859-407-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. BIJALKUMAR J PATEL
Title or Position: OWNER,RPH
Credential:
Phone: 859-407-4135