Active NPI
Swedishamerican Hospital
- Community/Retail Pharmacy
- Rockford, IL
National Provider Identifier
1013401033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SWEDISHAMERICAN HOSPITAL
- Practice address
- 1401 E State St
Rockford, IL 61104-2315 - Phone
- (815) 968-4400
- NPI assigned
- Jun 22, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Born
- Title
- Ceo
- Phone
- (779) 696-4400
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
1401 E State St
Rockford, IL 61104-2315
Mailing address
1401 E State St
Rockford, IL 61104-2315
Phone (815) 968-4400
Other names 1
- SWEDISHAMERICAN HOSPITAL PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180830002275 | IL | DME Supplier - Pharmacy | 5799698346 | Practice locations: Rockford, IL |
Other NPIs with the same Medicare PAC ID 7
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
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Practitioners & affiliated clinicians
Practitioners 386
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529625600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529625600000",
"number": "1013401033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042315",
"telephone_number": "815-968-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042315",
"telephone_number": "815-968-4400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SWEDISHAMERICAN HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2018-06-22",
"last_updated": "2018-06-22",
"status": "A",
"authorized_official_last_name": "BORN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "779-696-4400"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SWEDISHAMERICAN HOSPITAL PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "SWEDISHAMERICAN HOSPITAL PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.