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General NPI Number Information
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NPI Number | 1255788113
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Entity Type | Organization
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Legal Business Name | CLIFTON HEALTH SYSTEMS, LLC
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Dates
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Enumeration Date | 05/20/2016
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 973 FEATHERSTONE RD STE 340
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City | ROCKFORD
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State | IL
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Zip | 61107-5908
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Country | US
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Telephone | 779-216-5522
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Fax | 779-216-5520
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Provider Business Mailing Address
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Address Line | 973 FEATHERSTONE RD STE 340
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City | ROCKFORD
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State | IL
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Zip | 61107-5908
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Country | US
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Telephone | 779-216-5522
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Fax | 779-216-5520
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MARI COLATORTI
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Credential |
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Telephone | 779-216-5524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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