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
—
—
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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