Organization
KETY INC
Active
Other names
The Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RON MCDERMOTT (SVP OPERATIONS)
(330) 318-3926
Entity
Organization
Contact information
Practice address
3589 BRODHEAD RD, MONACA, PA 15061-3138
(724) 774-2990
(724) 774-6832
Mailing address
8571 FOXWOOD CT, POLAND, OH 44514-4313
(330) 318-3926
(330) 318-3927
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP415299L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032785520
—
PA
01
—
2167353
PK
—
Enumeration date
07/13/2006
Last updated
04/28/2017
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