MEDICARE: HOMETOWN WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1093597262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN WELLNESS LLC

Provider Business Mailing Address
First Line	:	2201 SW 28TH ST # VILLA84
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34974-5703
Country	:	US
Telephone Number	:	863-634-4218
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 NE PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-2923
Country	:	US
Telephone Number	:	863-484-6020
Fax Number	:	863-484-6017

Authorized Official
Title or Position	:	APRN
Name	:	MRS. TAMMY THERESA HEDRICK
Credential	:	APRN
Telephone Number	:	863-634-4218

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	05/02/2025

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Directions to “HOMETOWN WELLNESS LLC ” Practice Location

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