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Organization
OREGON HOMETOWN PHARMACY LLC
Active
Organization
OREGON HOMETOWN PHARMACY LLC
Active
Other names
Oregon Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HALEY STOCKS (CONTRACTING SPECIALIST)
(920) 992-6800
Entity
Organization
Contact information
Practice address
815 N MAIN ST, OREGON, WI 53575
(608) 835-3191
(608) 835-5467
Mailing address
333 LOWVILLE RD, RIO, WI 53960-9437
(920) 992-6800
(920) 992-6801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
9189-42
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029682
—
WI
Enumeration date
02/22/2013
Last updated
04/07/2022
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