# ROSELAND COMMUNITY HOSPITAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The New Roseland Outpatient Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619417979
- **Authorized official:** MARLO KEMP RPH (CFO, AO)
- **Authorized official phone:** (773) 995-6502

## Contact information

- **Practice address:** 45 W 111TH ST, CHICAGO, IL 60628-4200
- **Practice address phone:** (773) 291-1684
- **Practice address fax:** (773) 291-1685
- **Mailing address:** 45 W 111TH ST, CHICAGO, IL 60628-4200
- **Mailing address phone:** (773) 291-1684
- **Mailing address fax:** (773) 291-1685

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054020279 | IL | Yes |

## Other

- **Enumeration date:** 03/06/2017
- **Last updated:** 05/26/2017