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
—
—
333600000X
Pharmacy
9189-42
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
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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