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Organization

HUNT SILVER LAKE DRUG INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILIP HOMMERDING (OWNER)
(507) 289-3901
Entity
Organization

Contact information

Practice address
1512 BROADWAY AVE N, ROCHESTER, MN 55906
(507) 288-3831
(507) 252-1731
Mailing address
1512 N BROADWAY, ROCHESTER, MN 55906-4146
(507) 288-3831
(507) 252-1731

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336L0003X
Long Term Care Pharmacy
264484
MN
3336L0003X
Long Term Care Pharmacy
264485
MN
3336L0003X
Long Term Care Pharmacy
265449
MN
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2407749
NCPDP #
01
265766
LICENSE
MN
05
610023600
MN
Enumeration date
09/21/2005
Last updated
02/24/2026
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