Hometown Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Appomattox, VA
NPI 1891894754 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1891894754
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 0201003970 (VA)
- Legal business name
- HOMETOWN PHARMACY LLC
- Practice address
- 199 Old Courthouse Rd
Appomattox, VA 24522-9853 - Phone
- (434) 352-3784
- Fax
- (434) 352-3717
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Lisa Smith
- Title
- Owner
- Phone
- (434) 352-3784
Other NPIs on the same Medicare enrollment 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2193337 | Hometown Pharmacy LLC | Certificate of waiver | Sep 20, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090624000378 | VA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1557412012 |
1 other NPI on this enrollment Practice locations: Appomattox, VA; Madison Heights, VA |
National Provider Directory
Locations
199 Old Courthouse Rd
Appomattox, VA 24522
Phone (434) 352-3784
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 0201003970 | VA | Yes |
Addresses
Primary practice location
199 Old Courthouse Rd
Appomattox, VA 24522-9853
Mailing address
199 Old Courthouse Rd
Appomattox, VA 24522-9853
Phone (434) 352-3784
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010128323 | Medicaid | VA | |
| 2105476 | Other | PK |
Other names
- HOMETOWN PHARMACY
Other providers in Appomattox, VA
- Richard Gene Hansson
- Harman Eye Center of Appomattox and Associates PLC
- Shana Harvey
- Larry Wayne Hoff
- John A Hoffman
- Joetricia Humbles
- Brittany Leanne James
- Kanawha Medical Supply, Inc.
- Stephen E King
- Claire Lynnette Kirkbride
All providers in Appomattox, VA · Community/Retail Pharmacy in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.