Organization
HOMETOWN PHARMACY INC
Active
Other names
SWANSTRA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO PHARM D., MBA (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
3 W MONROE ST, BANGOR, MI 49013-1351
(269) 427-7706
(269) 427-5752
Mailing address
3 W MONROE ST, BANGOR, MI 49013-1351
(269) 427-7706
(269) 427-5752
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008451
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042228
PK
—
05
—
4916115
—
MI
Enumeration date
04/13/2006
Last updated
04/10/2020
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