Healthcare Provider Details

I. General information

NPI: 1548368871
Provider Name (Legal Business Name): FOREST HILLS PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 W 81ST ST
JUSTICE IL
60458-1350
US

IV. Provider business mailing address

9050 W 81ST ST
JUSTICE IL
60458-1350
US

V. Phone/Fax

Practice location:
  • Phone: 708-594-3000
  • Fax: 708-594-7246
Mailing address:
  • Phone: 708-594-3000
  • Fax: 708-594-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number054005710
License Number StateIL

VIII. Authorized Official

Name: PHILLIP L GUASTELLA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 708-594-3000