NPI | 1053306845 |
---|---|
Doing Business As | HOMETOWN PHARMACY #55 - WALKER |
Entity Type | Organization |
Authorized Contact | REBEKAH LYN DESARMO Executive Operations Administrator 231-652-7810 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301011126) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy | |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2005-09-16 |
Last Update Date | 2020-04-10 |