Organization
HOMETOWN PHARMACY INC
Active
Organization
HOMETOWN PHARMACY INC
Active
Other names
HomeTown Pharmacy #21 - Shelby
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO PHARM D., MBA (VP OF ADMINISTRATION)
(231) 861-6902
Entity
Organization
Contact information
Practice address
178 N MICHIGAN AVE, SHELBY, MI 49455-1028
(231) 861-4341
(231) 861-6609
Mailing address
4171 S OCEANA DR, NEW ERA, MI 49446-9781
(231) 861-6900
(231) 861-7177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301005684
MI
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215014311
—
MI
01
—
2119693
PK
—
Enumeration date
11/01/2006
Last updated
04/23/2024
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