Healthcare Provider Details

I. General information

NPI: 1487534087
Provider Name (Legal Business Name): HOMETOWN HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 PARKWAY PLZ
KOSCIUSKO MS
39090-3217
US

IV. Provider business mailing address

107 E WASHINGTON ST
HOUSTON MS
38851-2225
US

V. Phone/Fax

Practice location:
  • Phone: 662-516-8162
  • Fax: 888-958-5516
Mailing address:
  • Phone: 662-456-4630
  • Fax: 662-456-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KEVIN S KILGORE
Title or Position: PRESIDENT
Credential:
Phone: 662-456-4630