Organization
HOMETOWN PHARMACY INC
Active
Other names
HomeTown Pharmacy #65 - Medical Campus
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO PHARM D., MBA (VP OF FINANCE)
(231) 861-6902
Entity
Organization
Contact information
Practice address
550 MUNSON AVE STE G100, TRAVERSE CITY, MI 49686-3580
(231) 935-8730
(231) 935-8741
Mailing address
4171 S OCEANA DR, NEW ERA, MI 49446-9781
(231) 861-6900
(231) 861-7177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366430423
—
MI
Enumeration date
10/12/2005
Last updated
03/19/2025
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