Provider Demographics
NPI:1174220305
Name:HOMETOWN PHARMACY OF RICHMOND
Entity type:Organization
Organization Name:HOMETOWN PHARMACY OF RICHMOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRTIBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-421-9625
Mailing Address - Street 1:2002 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8167
Mailing Address - Country:US
Mailing Address - Phone:859-421-9625
Mailing Address - Fax:877-900-0464
Practice Address - Street 1:2002 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8167
Practice Address - Country:US
Practice Address - Phone:859-421-9625
Practice Address - Fax:877-900-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP08269OtherPHARMACY PERMIT