Provider Demographics
NPI:1699378489
Name:HOMETOWN PHARMACY OF LAWRENCEBURG
Entity type:Organization
Organization Name:HOMETOWN PHARMACY OF LAWRENCEBURG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER,RPH
Authorized Official - Prefix:MR
Authorized Official - First Name:BIJALKUMAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-517-0888
Mailing Address - Street 1:1185 GLENSBORO RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-9089
Mailing Address - Country:US
Mailing Address - Phone:502-517-0888
Mailing Address - Fax:502-517-0889
Practice Address - Street 1:1185 GLENSBORO RD STE 5
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9089
Practice Address - Country:US
Practice Address - Phone:502-517-0888
Practice Address - Fax:502-517-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP08156OtherPHARMACY PERMIT