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General NPI Number Information
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NPI Number | 1497176564
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Entity Type | Organization
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Legal Business Name | HOMETOWN PHARMACY OF LIMESTONE COUNTY, LLC
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 100 HIGHWAY 31 SUITE H
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City | ATHENS
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State | AL
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Zip | 35611
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Country | US
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Telephone | 256-232-8448
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Fax | 256-232-1302
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Provider Business Mailing Address
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Address Line | 1406 LINDSAY LN S STE A
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City | ATHENS
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State | AL
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Zip | 35613-2710
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Country | US
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Telephone | 256-233-7070
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Fax | 256-233-8891
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Authorized Official
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Title or Position | OWNER/AO/PHARMACIST
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Name | MONIQUE CANNON
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Credential | PHARMD
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Telephone | 256-233-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 114259
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License Number State | AL
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