Healthcare Provider Details

I. General information

NPI: 1437472040
Provider Name (Legal Business Name): HOMETOWN HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

797 S GLOSTER ST
TUPELO MS
38801-4903
US

IV. Provider business mailing address

797 S GLOSTER ST
TUPELO MS
38801-4903
US

V. Phone/Fax

Practice location:
  • Phone: 662-840-5202
  • Fax: 662-840-5205
Mailing address:
  • Phone: 662-840-5202
  • Fax: 662-840-5205

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: MR. KEVIN SCOTT KILGORE
Title or Position: PRESIDENT
Credential:
Phone: 662-456-4630