Organization
HOMETOWN PHARMACY INC
Active
Other names
Hometown Pharmacy #53 - Muskegon
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
5866 HARVEY ST, MUSKEGON, MI 49444-6720
(231) 563-6237
(231) 563-6391
Mailing address
5866 HARVEY ST, MUSKEGON, MI 49444-6720
(231) 563-6237
(231) 563-6391
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306208483
—
MI
01
—
2159043
PK
—
Enumeration date
03/28/2016
Last updated
04/13/2020
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