MEDICARE: HUNT SILVER LAKE DRUG INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2407749	OTHER		NCPDP #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	265766	OTHER	MN	LICENSE

General Provider Information

NPI Number	:	1700872280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNT SILVER LAKE DRUG INC

Provider Business Mailing Address
First Line	:	1512 N BROADWAY
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-4146
Country	:	US
Telephone Number	:	507-288-3831
Fax Number	:	507-252-1731

Provider Business Practice Location Address
First Line	:	1512 BROADWAY AVE N
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906
Country	:	US
Telephone Number	:	507-288-3831
Fax Number	:	507-252-1731

Authorized Official
Title or Position	:	OWNER
Name	:	PHILIP HOMMERDING
Credential	:
Telephone Number	:	507-289-3901

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	02/24/2026

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Directions to “HUNT SILVER LAKE DRUG INC ” Practice Location

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