Organization
SWEDISH AMERICAN HOSPITAL
Active
Other names
Swedish American DME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH NELSON (VICE PRESIDENT OF OPERATIONS)
(815) 961-2030
Entity
Organization
Contact information
Practice address
2550 CHARLES ST, ROCKFORD, IL 61108-1673
(815) 391-7574
(815) 391-7501
Mailing address
2550 CHARLES ST, ROCKFORD, IL 61108-1673
(815) 391-7574
(815) 391-7501
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000157
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10132143
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/04/2006
Last updated
10/29/2009
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