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Organization
ROSELAND COMMUNITY HOSPITAL ASSOCIATION
Active
Organization
ROSELAND COMMUNITY HOSPITAL ASSOCIATION
Active
Other names
The New Roseland Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARLO KEMP RPH (CFO, AO)
(773) 995-6502
Entity
Organization
Contact information
Practice address
45 W 111TH ST, CHICAGO, IL 60628-4200
(773) 291-1684
(773) 291-1685
Mailing address
45 W 111TH ST, CHICAGO, IL 60628-4200
(773) 291-1684
(773) 291-1685
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054020279
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167786
PK
—
Enumeration date
03/06/2017
Last updated
05/26/2017
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