HOMETOWN FAMILY PRACTICE LLC NPI 1720687007

NPI Information

NPI: 1720687007
Provider Name: HOMETOWN FAMILY PRACTICE, LLC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
CLIA Number: 36D2201119
Address: 1198 WESTWOOD DR STE F
VAN WERT, OH
ZIP 45891
Phone: (419) 771-1640

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NPI Details

HOMETOWN FAMILY PRACTICE, LLC is a primary care clinic center in Van Wert, OH. HOMETOWN FAMILY PRACTICE, LLC NPI is 1720687007. The provider is registered as an organization entity type.

The provider's business location address is:

1198 WESTWOOD DR STE F
VAN WERT, OH
ZIP 45891-478
Phone: (419) 771-1640

The provider's authorized official is Christine Ulrich .
The authorized official title is Nurse Practitioner and has the following contact phone number (419) 771-1640.

The CLIA number assigned to this NPI record is 36D2201119 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2020 and was last updated on 4/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1619955754	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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