Organization
HOMETOWN PHARMACY INC
Active
Parent organization
HOMETOWN PHARMACY INC.
Other names
Hometown Pharmacy #51 - Grand Rapids
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOMETOWN PHARMACY INC.
Authorized official
REBEKAH LYN DESARMO (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
4252 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-3607
(616) 281-1323
(616) 281-1330
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010897
MI
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158175
PK
—
Enumeration date
08/24/2006
Last updated
04/14/2020
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