MEDICARE: HOMETOWN URGENT CARE AND FAMILY MEDICINE

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1598486755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN URGENT CARE AND FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	10080 ROAD 539
Second Line	:
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-8086
Country	:	US
Telephone Number	:	601-504-3424
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 MAIN ST
Second Line	:
City	:	UNION
State	:	MS
Zip	:	39365-2521
Country	:	US
Telephone Number	:	601-504-3424
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PHILLIP MILLER
Credential	:	APRN
Telephone Number	:	601-504-3424

Provider Enumeration Date	:	09/07/2022
Last Update Date	:	09/07/2022

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Directions to “HOMETOWN URGENT CARE AND FAMILY MEDICINE ” Practice Location

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