Organization
HOMETOWN PHARMACY INC
Active
Other names
Martz & Shapley 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
101 MAPLE ST, BIG RAPIDS, MI 49307-1803
(231) 796-7621
(231) 796-1050
Mailing address
101 MAPLE ST, BIG RAPIDS, MI 49307-1803
(231) 796-7621
(231) 796-1050
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301006731
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2044105
PK
—
05
—
3456530
—
MI
Enumeration date
04/13/2006
Last updated
04/14/2020
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