Organization
HOME TOWN PHARMACY INC
Active
Parent organization
HOME TOWN PHARMACY INC
Other names
HomeTown Pharmacy #48 - Mishawaka
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOME TOWN PHARMACY INC
Authorized official
REBEKAH LYN DESARMO PHARM D., MBA (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
606 N MAIN ST, MISHAWAKA, IN 46545-6620
(574) 255-2988
(574) 258-5945
Mailing address
PO BOX 884, NEWAYGO, MI 49337-0884
(231) 652-7810
(231) 652-7876
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60006398A
BOARD OF PHARMACY
IN
01
—
60006398B
CONTROLLED SUBSTANCE
IN
Enumeration date
01/13/2020
Last updated
03/07/2023
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