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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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