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Organization
HIGHLAND PARK CVS, L.L.C.
Active
Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS PHARMACY 02713
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
753 WEST HWY 50, OFALLON, IL 62269
(618) 624-3561
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
054-014332
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1471781
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/19/2006
Last updated
03/08/2012
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