NPIMap

Organization Active NPI

Hometown Pharmacy Inc

Doing business as Hometown Pharmacy #49 - Warsaw

  • Community/Retail Pharmacy
  • Warsaw, IN
National Provider Identifier
1093819047
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60006450A Issued in IN
Legal business name
HOMETOWN PHARMACY INC
Doing business as
Hometown Pharmacy #49 - Warsaw
Practice address
1775 E Center St
Warsaw, IN 46580-3603
Phone
(574) 267-7194
Fax
(574) 267-1599
NPI assigned
Sep 12, 2006
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rebekah Lyn Desarmo, PHARM D., MBANPI 1487904736
Title
VP of Administration
Phone
(231) 861-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 60006450A IN Primary

Addresses

Primary practice location

1775 E Center St
Warsaw, IN 46580-3603

Mailing address

4171 S Oceana Dr
New Era, MI 49446-9781
Phone (231) 861-6900

Other identifiers 1

IdentifierTypeStateIssuer
2151378OtherPK

Other names 1

  • Hometown Pharmacy #49 - Warsaw Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151001001099 IN Part B Supplier - Mass Immunization (Roster Biller Only) 2668544107 Practice locations: Warsaw, IN

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1775 E Center St
Warsaw, IN 46580
Phone (574) 267-7356

1775 E Center St
#49
Warsaw, IN 46580
Phone (574) 267-7356

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1093819047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4171 S OCEANA DR",
            "city": "NEW ERA",
            "state": "MI",
            "postal_code": "494469781",
            "telephone_number": "231-861-6900",
            "fax_number": "231-861-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 E CENTER ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803603",
            "telephone_number": "574-267-7194",
            "fax_number": "574-267-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "DESARMO",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "VP OF ADMINISTRATION",
        "authorized_official_telephone_number": "231-861-6900",
        "authorized_official_credential": "PHARM D., MBA"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60006450A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151378",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Pharmacy #49 - Warsaw",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hometown Pharmacy #49 - Warsaw",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.