HOME TOWN PHARMACY INC (NPI# 1366082935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366082935 |
| Entity Type | Organization |
| Organization Name | HOME TOWN PHARMACY INC |
| Practice Address |
1114 W South Airport Rd Traverse City MI 49686-4739 |
| Mailing Address |
Po Box 884 Newaygo MI 49337-0884 |
| Practice Telephone | 2319460900 |
| Practice Fax Number | 2319460969 |
| Mailing Telephone | 2316527810 |
| Mailing Fax Number | 2316527876 |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |
| Authorized Official Name | REBEKAH LYN DESARMO (EXECUTIVE OPERATIONS ADMINISTRATOR) |
| Authorized Official Telephone | 2316527810 |
| Authorized Official Credential | PHARM D., MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | HOME TOWN PHARMACY INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BOARD OF PHARMACY | 5301010265 | 01 |
| MI | CONTROLLED SUBSTANCE | 5315063263 | 01 |
| Other Name | Type Code |
|---|---|
| HomeTown Pharmacy #46 - TC East | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982701868 | Home Town Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 5277 Lapeer Rd, Kimball, MI 48074 | 2006-09-20 |
| 1659335172 | Home Town Pharmacy Inc | Pharmacy | 133 E Division, Sparta, MI 49345 | 2006-04-13 |
| 1275173841 | Home Town Pharmacy Inc | Pharmacy | 606 N Main St, Mishawaka, IN 46545-6620 | 2020-01-13 |
| 1447890017 | Home Town Pharmacy Inc | Pharmacy | 5277 Lapeer Rd, Kimball, MI 48074-1422 | 2020-01-13 |
| 1356981922 | Home Town Pharmacy Inc | Pharmacy | 4252 Kalamazoo Ave Se, Grand Rapids, MI 49508-3607 | 2020-01-13 |
| 1558901124 | Home Town Pharmacy Inc | Pharmacy | 110 S Clinton St, Stockbridge, MI 49285-9148 | 2020-01-13 |
| 1184264889 | Home Town Pharmacy Inc | Pharmacy | 2355 E Stadium Blvd, Ann Arbor, MI 48104-4800 | 2020-01-10 |
| 1104467323 | Home Town Pharmacy Inc | Pharmacy | 60 E 82nd St, Newaygo, MI 49337-8005 | 2019-09-30 |
| Street Address |
1114 W SOUTH AIRPORT RD |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686-4739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528499878 | Munson Services, Inc. | Pharmacy | 550 Munson Ave, Suite G-100, Traverse City, MI 49686-3580 | 2013-12-11 |
| 1053684084 | Muson Services, Inc. | Pharmacy | 550 Munson Ave, Suite G-100, Traverse City, MI 49686-3580 | 2012-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437772159 | Krx Medication Consultants | Pharmacy | 8266 Fernwood St, Augusta, MI 49012 | 2020-05-28 |
| 1235751306 | Ypsilanti Family Pharmacy, Inc. | Pharmacy | 2287 Ellsworth Rd Ste A, Ypsilanti, MI 48197-4805 | 2020-05-12 |
| 1619510328 | Great Lakes Pharmacies I Inc | Pharmacy | 6213 Chicago Rd Ste 200, Warren, MI 48092-1697 | 2019-10-25 |
| 1710520143 | H & L Drugs Inc | Pharmacy | 1455 S Lapeer Rd Ste 101, Lake Orion, MI 48360-1468 | 2019-10-17 |
| 1225688229 | Guardian Pharmacy of Grand Rapids, LLC | Pharmacy | 2930 29th St Se, Grand Rapids, MI 49512-1723 | 2019-09-12 |
| 1457905259 | Senior Care Rx LLC | Pharmacy | 24293 Telegraph Rd Ste 130, Southfield, MI 48033-7924 | 2019-07-30 |
| 1063071637 | Smart Rx LLC | Pharmacy | 25464 Van Born Rd, Dearborn Heights, MI 48125 | 2019-06-07 |
| 1457812117 | Pharmtek LLC | Pharmacy | 3307 Orchard Lake Rd, Keego Harbor, MI 48320-1308 | 2019-03-26 |
| 1801350772 | Prestige Specialty Pharmacy 2 | Pharmacy | 31700 Van Dyke Ave Ste B, Warren, MI 48093-7949 | 2019-01-24 |
| 1194296707 | Palmer Ltc Pharmacy LLC | Pharmacy | 4020 Venoy Rd Ste 900b, Wayne, MI 48184-4818 | 2018-12-07 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.