# CEDARVILLE HOMETOWN PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cedar Care Village Pharmacy, Cedar Care Village Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730545229
- **Authorized official:** KATHERINE PERRY (OWNER)
- **Authorized official phone:** (937) 336-3637

## Contact information

- **Practice address:** 63 N. MAIN ST., CEDARVILLE, OH 45314
- **Practice address phone:** (937) 766-2273
- **Practice address fax:** (937) 697-5086
- **Mailing address:** PO BOX 662, CEDARVILLE, OH 45314
- **Mailing address phone:** (937) 766-2273
- **Mailing address fax:** (937) 697-5086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 022553950 | OH | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/13/2016
- **Last updated:** 11/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 023000050 | OHIO BOARD OF PHARMACY TERMINAL DISTRIBUTORS LICENSE | OH |
| 05 | — | 0332877 | — | OH |