HOME TOWN PHARMACY INC NPI 1356981922

NPI Information

HOME TOWN PHARMACY INC is a long term care pharmacy pharmacy in Grand Rapids, MI. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. HOME TOWN PHARMACY INC NPI is 1356981922. The provider is registered as an organization entity type.

The provider's business location address is:

4252 KALAMAZOO AVE SE
GRAND RAPIDS, MI
ZIP 49508-607
Phone: (616) 281-1323
Fax: (616) 281-1330

The provider's authorized official is Rebekah Lyn Desarmo .
The authorized official title is Executive Operations Administrator and has the following contact phone number (231) 652-7810.

The CLIA number assigned to this NPI record is 23D1009302 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2020 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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