Organization
HOMETOWN PHARMACY INC
Active
Other names
MOMBER'S 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
11 S STATE ST, SPARTA, MI 49345-1718
(616) 887-7323
(616) 887-9559
Mailing address
11 S STATE ST, SPARTA, MI 49345-1718
(616) 887-7323
(616) 887-9559
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008321
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2040569
PK
—
05
—
2512518
—
MI
Enumeration date
06/19/2006
Last updated
04/10/2020
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