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NPI Code Detail

MEDICARE: HOMETOWN PHARMACY INC

MEDICARE: HOMETOWN PHARMACY 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
1333600000XPharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
33336C0003XCommunity/Retail Pharmacy5301007837MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12046686OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922062439
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOMETOWN PHARMACY INC
Provider Business Mailing Address
First Line : 4171 S OCEANA DR
Second Line :
City : NEW ERA
State : MI
Zip : 49446-9781
Country : US
Telephone Number : 231-861-6900
Fax Number : 231-861-7177
Provider Business Practice Location Address
First Line : 1125 S MAIN ST
Second Line :
City : CHELSEA
State : MI
Zip : 48118-1426
Country : US
Telephone Number : 734-475-1188
Fax Number : 734-475-4330
Authorized Official
Title or Position : VP OF FINANCE
Name : REBEKAH LYN DESARMO
Credential : PHARM D., MBA
Telephone Number : 231-861-6902
Provider Enumeration Date : 04/12/2006
Last Update Date : 06/14/2026

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Directions to “HOMETOWN PHARMACY INC ” Practice Location

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