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General NPI Number Information
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NPI Number | 1952660391
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Entity Type | Organization
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Legal Business Name | HOMETOWN DRUG INC
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 2508 GRAY ST
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City | HOPEWELL
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State | VA
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Zip | 23860-5026
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Country | US
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Telephone | 804-458-3784
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Fax | 804-458-6450
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Provider Business Mailing Address
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Address Line | 2508 GRAY ST
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City | HOPEWELL
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State | VA
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Zip | 23860-5026
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Country | US
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Telephone | 804-458-3784
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Fax | 804-458-6450
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Authorized Official
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Title or Position | PRESIDENT/RPH
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Name | GEORGE FETKO
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Credential |
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Telephone | 540-808-9227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201004462
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License Number State | VA
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