Provider Demographics
NPI:1710490909
Name:NORTHWEST COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:NORTHWEST COMMUNITY HOSPITAL
Other - Org Name:NORTHWEST COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:O
Authorized Official - Last Name:SCOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-618-5000
Mailing Address - Street 1:800 W CENTRAL ROAD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2349
Mailing Address - Country:US
Mailing Address - Phone:847-618-7427
Mailing Address - Fax:847-618-7429
Practice Address - Street 1:800 W CENTRAL ROAD
Practice Address - Street 2:SUITE 1100
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60010-2349
Practice Address - Country:US
Practice Address - Phone:847-618-7427
Practice Address - Fax:847-618-7429
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
054.0204833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy