Provider Demographics
NPI:1457792194
Name:HOMETOWN HOMECARE LLC
Entity type:Organization
Organization Name:HOMETOWN HOMECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-920-1501
Mailing Address - Street 1:2101 W ARKANSAS ST
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-5643
Mailing Address - Country:US
Mailing Address - Phone:580-920-1501
Mailing Address - Fax:
Practice Address - Street 1:5801 ULMERTON RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3905
Practice Address - Country:US
Practice Address - Phone:727-953-9802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMETOWN HOMECARE HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-10
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health