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General NPI Number Information
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NPI Number | 1588420616
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Entity Type | Organization
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Legal Business Name | MCDONOUGH COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 533 E GRANT STREET
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City | MACOMB
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State | IL
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Zip | 61455
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Country | US
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Telephone | 516-639-8151
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Fax |
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Provider Business Mailing Address
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Address Line | 525 E GRANT STREET ATTN: MDH COMMUNITY PHARMACY
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City | MACOMB
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State | IL
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Zip | 61455
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Country | US
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Telephone | 516-639-8151
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COMMUNITY PHARMACY
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Name | DR. NICOLE CHRISTINA DZIUBA
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Credential | PHARMD
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Telephone | 516-639-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number |
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License Number State |
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