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General NPI Number Information
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NPI Number | 1649281205
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Entity Type | Organization
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Legal Business Name | ST HENRY HOMETOWN PHARMACY
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 451 STACHLER DR
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City | ST HENRY
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State | OH
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Zip | 45883
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Country | US
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Telephone | 419-678-7901
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Fax | 419-678-1413
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Provider Business Mailing Address
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Address Line | 660 ELIDA AVE
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City | DELPHOS
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State | OH
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Zip | 45833-1735
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL PATTON
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Credential |
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Telephone | 419-692-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | OH
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