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NPI Code Detail

MEDICARE: FOREST HILLS PHARMACY INC.

MEDICARE: FOREST HILLS PHARMACY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2183500000XPharmacist054005710IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10980650001OTHERILMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21430507OTHERILNABP

General Provider Information

NPI Number : 1548368871
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOREST HILLS PHARMACY INC.
Provider Business Mailing Address
First Line : 9050 W 81ST ST
Second Line :
City : JUSTICE
State : IL
Zip : 60458-1350
Country : US
Telephone Number : 708-594-3000
Fax Number : 708-594-7246
Provider Business Practice Location Address
First Line : 9050 W 81ST ST
Second Line :
City : JUSTICE
State : IL
Zip : 60458-1350
Country : US
Telephone Number : 708-594-3000
Fax Number : 708-594-7246
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : PHILLIP L GUASTELLA
Credential :
Telephone Number : 708-594-3000
Provider Enumeration Date : 09/20/2006
Last Update Date : 10/24/2019

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Directions to “FOREST HILLS PHARMACY INC. ” Practice Location

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