Provider Demographics
NPI:1386170611
Name:HOMETOWN PHARMACY OF FRANKFORT , PLLC
Entity type:Organization
Organization Name:HOMETOWN PHARMACY OF FRANKFORT , PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER , RPH
Authorized Official - Prefix:MR
Authorized Official - First Name:BIJALKUMAR
Authorized Official - Middle Name:JAYANTILAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-699-2440
Mailing Address - Street 1:1140 US HIGHWAY 127 S
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4360
Mailing Address - Country:US
Mailing Address - Phone:502-699-2440
Mailing Address - Fax:502-699-2445
Practice Address - Street 1:1140 US HIGHWAY 127 S
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4360
Practice Address - Country:US
Practice Address - Phone:502-699-2440
Practice Address - Fax:502-699-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
KYP07843333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100470770Medicaid
KY7643490001OtherMEDICARE
KYP07843OtherPHARMACY PERMIT
KY1836052OtherNCPDP