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General NPI Number Information
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NPI Number | 1265593784
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Entity Type | Organization
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Legal Business Name | SAINT ELIZABETH HOSPITAL PHARMACY
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1431 N CLAREMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60622-1702
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Country | US
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Telephone | 312-633-5946
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 N CLAREMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60622-1702
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Country | US
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Telephone | 312-633-5946
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, PHARMACY
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Name | MR. JOSEPH MA
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Credential |
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Telephone | 312-633-5936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 059013460
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License Number State | IL
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