Organization
HOME TOWN PHARMACY INC
Active
Parent organization
HOME TOWN PHARMACY INC
Other names
HomeTown Pharmacy #51 Grand Rapids
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
4252 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-3607
(616) 281-1323
(616) 281-1330
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
—
5301010897
BOARD OF PHARMACY
MI
01
—
5315074625
CONTROLLED SUBSTANCE
MI
Enumeration date
01/13/2020
Last updated
03/07/2023
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