Hometown Pharmacy #55 - Walker
LBN: Hometown Pharmacy Inc
Hometown Pharmacy #55 - Walker is an health care organization with primary practice located at 1181 Walker Ave Nw , Grand Rapids MI 49504-7404. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Hometown Pharmacy Inc can be contacted via phone (616) 458-9640, or through Desarmo, Rebekah Lyn via phone (231) 652-7810.
Contact Information
Primary practice address
1181 Walker Ave Nw
Grand Rapids MI 49504-7404
Phone: (616) 458-9640
Fax: (616) 458-6650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5301011126 | Michigan |
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1053306845 |
|---|---|
| LBN Legal business name | Hometown Pharmacy Inc |
| DBA Doing business as | Hometown Pharmacy #55 - Walker |
| Authorized official | Desarmo, Rebekah Lyn PHARM D., MBA |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 16th, 2005 |
| Last updated | Apr 10th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053306845 | NPPES |
| Other | 2168102 | PK | |
| MEDICAID | 1053306845 | PK |
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