NPIMap

Organization Active NPI

Hometown Pharmacy Inc

  • Community/Retail Pharmacy
  • New Era, MI
National Provider Identifier
1104467323
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HOMETOWN PHARMACY INC
Practice address
4171 S Oceana Dr
New Era, MI 49446-9781
Phone
(231) 861-6946
Fax
(231) 861-7177
NPI assigned
Sep 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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., MBA
Title
VP of Finance
Phone
(231) 861-6902

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

4171 S Oceana Dr
New Era, MI 49446-9781

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080627000613 MI Part B Supplier - Mass Immunization (Roster Biller Only) 2668544107 This NPI is an additional NPI on the enrollment
Practice locations: Shelby, MI; Muskegon, MI; New Buffalo, MI; New Era, MI; Newaygo, MI; Oxford, MI; Ravenna, MI; Reed City, MI…

National Provider Directory

National Provider Directory
Tax ID family
Hometown Pharmacy Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1104467323",
    "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": "4171 S OCEANA DR",
            "city": "NEW ERA",
            "state": "MI",
            "postal_code": "494469781",
            "telephone_number": "231-861-6946",
            "fax_number": "231-861-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "DESARMO",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "231-861-6902",
        "authorized_official_credential": "PHARM D., MBA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Era, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.