Organization
HOMETOWN PHARMACY INC
Active
Other names
Hometown Pharmacy #41 - Traverse City
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
4000 EASTERN SKY DR, SUITE 1, TRAVERSE CITY, MI 49684-7351
(231) 947-6921
(231) 947-4579
Mailing address
4000 EASTERN SKY DR, SUITE 1, TRAVERSE CITY, MI 49684-7351
(231) 947-6921
(231) 947-4579
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010223
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972558104
—
MI
01
—
2142382
PK
—
Enumeration date
05/24/2006
Last updated
04/14/2020
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