Depere Hometown Pharmacy
LBN: Depere Hometown Pharmacy Llc
Depere Hometown Pharmacy is an health care organization with primary practice located at 510 Redbird Cir , De Pere WI 54115-8785. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Depere Hometown Pharmacy Llc can be contacted via phone (920) 351-8155, or through Stocks, Haley via phone (920) 992-6800.
Contact Information
Primary practice address
510 Redbird Cir
De Pere WI 54115-8785
Phone: (920) 351-8155
Fax: (920) 632-7671
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | ||
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1730749672 |
|---|---|
| LBN Legal business name | Depere Hometown Pharmacy Llc |
| DBA Doing business as | Depere Hometown Pharmacy |
| Authorized official | Stocks, Haley CPHT |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 13th, 2019 |
| Last updated | May 24th, 2022 - 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 | 1730749672 | NPPES |
| Wisconsin | MEDICAID | 100090726 |
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