Hometown Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201004758 Issued in VA

Legal business name

HOMETOWN PHARMACY LLC

Doing business as

Hometown Pharmacy

Practice address

196 Amelon SQ
Madison Heights, VA 24572-5990

Phone

(434) 929-1000

Fax

(434) 929-1009

NPI assigned

Feb 27, 2017

Last updated

Mar 22, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Smith

Title

Owner

Phone

(434) 660-4421

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Hometown Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hometown Pharmacy LLC

  dba Hometown Pharmacy

  • Community/Retail Pharmacy
  • Appomattox, VA
  • NPI 1891894754

  O20090624000378

  Same enrollment

Locations

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1235679101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2408",
            "city": "APPOMATTOX",
            "state": "VA",
            "postal_code": "245222408",
            "telephone_number": "434-929-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 AMELON SQ",
            "city": "MADISON HEIGHTS",
            "state": "VA",
            "postal_code": "245725990",
            "telephone_number": "434-929-1000",
            "fax_number": "434-929-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-660-4421"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167627",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Latashi Gunn, PMHNP
• David S Haga, MD
• Christopher Hallberg, MAT, LAT, ATC
• Elizabeth Frances Hamilton
• Katherine L Hart
• Hometown Pharmacy LLC
• Horizon Behavioral Health (Warren House)
• Horizon Behavioral Health (Bowyer House)
• Candace Canada Hurt, CNA
• Emma Grace Podosek Igrison

• Community/Retail Pharmacy in Madison Heights, VA
• Providers in Madison Heights, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.