Organization
HOMETOWN PHARMACY INC
Active
Other names
HOMETOWN PHARMACY #37 - HDS
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
50 E 82ND ST, NEWAYGO, MI 49337-8005
(231) 652-7810
(231) 861-6920
Mailing address
50 E 82ND ST, NEWAYGO, MI 49337-8005
(231) 652-7810
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
5301009956
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2377516
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/24/2012
Last updated
04/14/2020
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