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General NPI Number Information
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NPI Number | 1821083890
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Entity Type | Organization
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Legal Business Name | HOMETOWN OLD COUNTRY PHARMACY, INC.
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 8534 RIDGE ROAD
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City | NEW PORT RICKEY
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State | FL
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Zip | 34654
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Country | US
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Telephone | 727-816-9770
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Fax | 727-817-1310
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Provider Business Mailing Address
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Address Line | 8534 RIDGE ROAD
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City | NEW PORT RICKEY
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State | FL
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Zip | 34654
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Country | US
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Telephone | 727-816-9770
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Fax | 727-817-1310
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Authorized Official
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Title or Position | MANAGEMENT MEMBER
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Name | SATVIK THAKKAR
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Credential |
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Telephone | 727-816-9770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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