HOMETOWN PHARMACY #4
NPI 1063513398
Pharmacy in Mount Vernon, MO
NPI Status: Active since September 26, 2006
Contact Information
606 E MOUNT VERNON BLVD
MOUNT VERNON, MO
ZIP 65712
Phone: (417) 466-2000
Fax: (417) 466-2028
- Organization
- Pharmacy
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 26D2307781
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 07-14-2026
About HOMETOWN PHARMACY #4
This page provides the complete NPI Profile along with additional information for Hometown Pharmacy #4, a provider established in Mount Vernon, Missouri operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1063513398 assigned on September 2006. The practitioner's primary taxonomy code is 333600000X with license number 2004011847 (MO). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Hometown Pharmacy #4. The authorized official of this NPI record is Charles Davin Vaughn Rph (President/owner)
- NPI
- 1063513398
- Provider Legal Name
- CARTHAGE PHARMACY SERVICES INC
- Other Organization Name
- HOMETOWN PHARMACY #4
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 606 E MOUNT VERNON BLVD MOUNT VERNON, MO 65712
- Location Phone
- (417) 466-2000
- Location Fax
- (417) 466-2028
- Mailing Address
- PO BOX 68 MOUNT VERNON, MO 65712
- Mailing Phone
- (417) 466-2000
- Mailing Fax
- (417) 466-2028
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-26-2006
- Last Update Date
- 11-14-2022
- Code Navigator
Hometown Pharmacy #4 is a medicare supplier with PTAN 20683511 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- License No.
- 2004011847
- License State
- MO
- Taxonomy Description
- A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 601917503 | MEDICAID (05) | MO |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Adm sarscv2 bvl 50mcg/.5ml a
Administration of influenza virus vaccine
Influenza vaccine split virus, preservative free
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use
The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.
This service was performed 20 times for 20 patientsThe administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 88 times for 84 patientsThe Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
This service was performed 30 times for 30 patientsThe quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
This service was performed 44 times for 44 patientsThe Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
This service was performed 14 times for 14 patientsMedical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20683511
- Accepts Medicare Assignment
- YES
- Specialities List
- Certified Other, Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D2307781
- Facility Type
- Pharmacy
- Certificate Effective Date
- July 15, 2024
- Certificate Expiration Date
- July 14, 2026
- Laboratory Director
- CHELSEA DOHERTY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Hometown Pharmacy #4 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for HOMETOWN PHARMACY #4
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063513398, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
MOUNT VERNON, MO 65712
MOUNT VERNON, MO 65712
MOUNT VERNON, MO 65712
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063513398, enumerated as an "organization" on September 26, 2006.
The provider is located at 606 E MOUNT VERNON BLVD MOUNT VERNON, MO 65712 and the phone number is (417) 466-2000.
Pharmacy with taxonomy code 333600000X.
The provider might be accepting Accepts: UnitedHealthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
