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RRC140281-00 NORTHWESTERN MEMORIAL HOSPITAL (Active)
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Main Details
Name
NORTHWESTERN MEMORIAL HOSPITAL
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC140281-00
Medicare Provider Number
140281
Additional Details
Current Program Status
Active
Registration Date
7/15/2020
Participating Start Date
8/7/2020
Participating Approval Date
7/31/2020
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Northwestern Memorial Hospital
Matthew Joseph Flynn, VP, Finance, NMHC
(312) 926-5236
Primary Contact
Northwestern Memorial Hospital
Richard Jacobson, Director of Pharmacy
(312) 926-3024
Addresses
Street Address
251 E HURON
CHICAGO, IL 60611
Billing Address
Northwestern Memorial Healthcare
Accounts Payable - PO Box 13776
Philadelphia, PA 19101-3776
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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