Organization
HOMETOWN PHARMACY INC
Active
Other names
GOBLES 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
212 S STATE ST, GOBLES, MI 49055-9410
(269) 628-2650
(269) 628-4022
Mailing address
PO BOX 403, GOBLES, MI 49055-0403
(269) 628-2650
(269) 628-4022
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301006436
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2043050
PK
—
05
—
3290325
—
MI
Enumeration date
04/12/2006
Last updated
04/14/2020
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