Hometown Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HOMETOWN MEDICAL SUPPLIES LLC

Practice address

3093 Wiljan CT Ste E
Santa Rosa, CA 95407-5750

Phone

(707) 800-3303

Fax

(707) 440-0318

NPI assigned

Jul 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kiley Ann Russell

Title

Senior Director of Payor Relations

Phone

(629) 252-8211

Specialties & licenses 2

Addresses

Other names 1

• Reliable Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Hometown Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Visalia, CA
  • NPI 1073251872

  5597960013

  Same PAC ID
• Hometown Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Stockton, CA
  • NPI 1750040465

  5597960013

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Hometown Medical Supplies LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Hometown Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Visalia, CA
  • NPI 1073251872
  NPD tax ID
• Hometown Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Stockton, CA
  • NPI 1750040465
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1104559236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9495 WINNETKA AVE N STE 200",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554451618",
            "telephone_number": "629-252-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3093 WILJAN CT STE E",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075750",
            "telephone_number": "707-800-3303",
            "fax_number": "707-440-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SENIOR DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "629-252-8211"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reliable Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Holt
• Kurt Andrew Holt, D.O.
• Laura Holtan
• Richard L. Holve, MD
• Home Health Care, Inc.
• Mark R Homicz, M.D.
• Rachel Elizabeth, Levine Honey, MFT
• Steven Hong
• Frans Matthew Malnassy Honig, DO
• Thomas J. Honrath, M.D.

• Durable Medical Equipment & Medical Supplies in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.