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Organization
HIGHLAND PARK CVS, L.L.C.
Active
Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS PHARMACY 06453
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
200 N MAIN ST, PEORIA, IL 61611-2549
(309) 694-1496
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
054-011784
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1448198
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/07/2006
Last updated
03/13/2012
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