Forum Extended Care Svc Inc Ii

LBN: Forum Extended Care Svc Inc Ii
Forum Extended Care Svc Inc Ii is an health care organization with primary practice located at 4201 W Victoria St , Chicago IL 60646-6700. The organization recently has 6 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Forum Extended Care Svc Inc Ii can be contacted via phone (847) 673-8727, or through Kramer, Brian via phone (847) 673-8727.

Contact Information

Primary practice address
4201 W Victoria St Chicago IL 60646-6700
Phone: (847) 673-8727
Fax: (847) 673-6215
Website:
Map and Directions
Authorized official contact:
Name: Kramer, Brian
Phone: (847) 673-8727

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 64001297A Indiana
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X
Suppliers / Institutional Pharmacy 3336I0012X 1204-43 Wisconsin
Suppliers / Long Term Care Pharmacy 3336L0003X 054017240 Illinois
Suppliers / Long Term Care Pharmacy 3336L0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1346291499
LBN Legal business name Forum Extended Care Svc Inc Ii
DBA Doing business as Forum Extended Care Svc Inc Ii
Authorized official Kramer, Brian
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2006
Last updated Apr 22nd, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346291499 NPPES
Illinois MEDICAID 36855933001
Illinois MEDICAID 33245400
Illinois Other 2022130
Illinois MEDICAID 201063520 A

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