Organization Name: | HOMETOWN DRUG INC |
NPI Number: | 1295173441 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANA COILE (OWNER/PIC) |
Mailing Address: | 718 W Lampasas St Ennis |
State: | TX US |
Postal Code: | 751194534 |
Phone Number: | 9728756798 |
Fax Number: | 9728752514 |
NPI Enumeration Date: | 06/10/2013 |
NPI Last Update Date: | 11/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | 28587 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Compounding Pharmacy |
Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |