Healthcare Provider Details

I. General information

NPI: 1639218381
Provider Name (Legal Business Name): HOMETOWN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 ROUTE 206 UNIT 9
SOUTHAMPTON NJ
08088-3558
US

IV. Provider business mailing address

1805 ROUTE 206 UNIT 9
SOUTHAMPTON NJ
08088-3558
US

V. Phone/Fax

Practice location:
  • Phone: 609-859-5633
  • Fax:
Mailing address:
  • Phone: 609-859-5633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00644000
License Number StateNJ

VIII. Authorized Official

Name: MR. TIMOTHY QUINLAN MURPHY
Title or Position: OWNER PHARMACIST
Credential: RPH
Phone: 609-859-5633