Organization
HOMETOWN PHARMACY INC.
Active
Other names
Hometown Pharmacy #48 - Mishawaka
Organization subpart
No
Provider details
NPI number
Authorized official
REBEKAH LYN DESARMO (EXECUTIVE OPERATIONS ADMINISTRATOR)
(231) 652-7810
Entity
Organization
Contact information
Practice address
606 N MAIN ST, MISHAWAKA, IN 46545-6620
(574) 255-2988
(574) 258-5945
Mailing address
606 N MAIN ST, MISHAWAKA, IN 46545-6620
(574) 255-2988
(574) 258-5945
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006398A
IN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146914
PK
—
Enumeration date
05/26/2006
Last updated
04/14/2020
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