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Organization
HOMETOWN PHARMACY INC
Active
Organization
HOMETOWN PHARMACY INC
Active
Other names
HomeTown Pharmacy #63 - Ambulatory
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO PHARM D., MBA (VP OF FINANCE)
(231) 861-6902
Entity
Organization
Contact information
Practice address
1105 SIXTH ST RM 2451, TRAVERSE CITY, MI 49684-2345
(231) 935-5678
(231) 935-6540
Mailing address
4171 S OCEANA DR, NEW ERA, MI 49446-9781
(231) 861-6900
(231) 861-7177
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336I0012X
Institutional Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730819574
—
MI
Enumeration date
06/14/2022
Last updated
03/19/2025
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