| NPI | 1063513398 |
|---|---|
| Doing Business As | HOMETOWN PHARMACY #4 |
| Entity Type | Organization |
| Authorized Contact | CHARLES DAVIN VAUGHN President/Owner 417-461-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2004011847) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-11-14 |