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General NPI Number Information
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NPI Number | 1730819574
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Entity Type | Organization
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Legal Business Name | HOMETOWN PHARMACY INC
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1105 SIXTH ST RM 2451
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2345
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Country | US
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Telephone | 231-935-5678
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Fax | 231-935-6540
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Provider Business Mailing Address
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Address Line | 4171 S OCEANA DR
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City | NEW ERA
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State | MI
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Zip | 49446-9781
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Country | US
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Telephone | 231-861-6900
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Fax | 231-861-7177
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | REBEKAH LYN DESARMO
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Credential | PHARM D., MBA
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Telephone | 231-861-6902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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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 #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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