MEDICARE: HOMETOWN PHARMACY INC

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1989577	OTHER		PK

General Provider Information

NPI Number	:	1720120173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN PHARMACY INC

Provider Business Mailing Address
First Line	:	2228 ALBERT PIKE RD STE B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-4089
Country	:	US
Telephone Number	:	501-760-5667
Fax Number	:	501-760-5744

Provider Business Practice Location Address
First Line	:	2228 ALBERT PIKE RD STE B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-4089
Country	:	US
Telephone Number	:	501-760-5667
Fax Number	:	501-760-5744

Authorized Official
Title or Position	:	PIC/PRESIDENT
Name	:	DAVID LECHAK
Credential	:	PD
Telephone Number	:	501-760-5667

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	03/04/2020

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Directions to “HOMETOWN PHARMACY INC ” Practice Location

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