| Organization Name: | HOMETOWN FAMILY MEDICINE PS |
| NPI Number: | 1881991131 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES M SACKMANN (MD-OWNER) |
| Mailing Address: | 210 W Main Ave Ritzville |
| State: | WA US |
| Postal Code: | 991691410 |
| Phone Number: | 5096594800 |
| Fax Number: | 5096594801 |
| NPI Enumeration Date: | 02/23/2011 |
| NPI Last Update Date: | 04/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |