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General NPI Number Information
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NPI Number | 1295035327
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Entity Type | Organization
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Legal Business Name | HOMETOWN PHARMACY MANAGEMENT LLC
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 110 LEROUX STREET
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City | DONIPHAN
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State | MO
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Zip | 63935-0000
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Country | US
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Telephone | 573-996-4000
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Fax | 573-996-3239
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Provider Business Mailing Address
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Address Line | 110 LEROUX STREET
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City | DONIPHAN
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State | MO
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Zip | 63935-0000
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Country | US
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Telephone | 573-996-4000
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Fax | 573-996-3239
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | CHRISTINE M COFFMAN
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Credential | PHARM.D.
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Telephone | 417-926-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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