Organization
HOMETOWN PHARMACY INC
Active
Other names
STOCKBRIDGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
110 S CLINTON ST, STOCKBRIDGE, MI 49285-9148
(517) 851-7575
(517) 851-9295
Mailing address
PO BOX 85, STOCKBRIDGE, MI 49285-0085
(517) 851-7575
(517) 851-9295
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007836
MI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046683
PK
—
05
—
4858942
—
MI
Enumeration date
04/13/2006
Last updated
04/14/2020
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