Provider Demographics
NPI:1104532613
Name:HOMETOWN PHARMACY SPECIALTY SERVICES, PLLC
Entity type:Organization
Organization Name:HOMETOWN PHARMACY SPECIALTY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELEIGHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:270-937-9008
Mailing Address - Street 1:3200 NEW COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9343
Mailing Address - Country:US
Mailing Address - Phone:270-937-9008
Mailing Address - Fax:270-937-9009
Practice Address - Street 1:3200 NEW COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9343
Practice Address - Country:US
Practice Address - Phone:270-937-9008
Practice Address - Fax:270-937-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy