Organization
NEW HOPE COMMUNITY SERVICE CENTER
Active
Other names
New Hope Community Service Center HEP Program
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDIA M BODLEY (MEDICAL BILLING OFFICE MAANAGER)
(773) 737-9555
Entity
Organization
Contact information
Practice address
2559 W 79TH ST, CHICAGO, IL 60652-1751
(773) 737-9555
(773) 737-0401
Mailing address
2559 W 79TH ST, CHICAGO, IL 60652-1751
(773) 737-9555
(773) 737-0401
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001356519714
—
IL
Enumeration date
05/10/2019
Last updated
05/10/2019
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