Provider Demographics
NPI:1184204042
Name:THE ARK
Entity type:Organization
Organization Name:THE ARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-973-1000
Mailing Address - Street 1:6450 N CALIFORNIA
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5209
Mailing Address - Country:US
Mailing Address - Phone:773-973-1009
Mailing Address - Fax:773-973-6865
Practice Address - Street 1:6450 N CALIFORNIA
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5209
Practice Address - Country:US
Practice Address - Phone:773-973-1009
Practice Address - Fax:773-973-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty