# HIGHLAND PARK CVS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS PHARMACY 01170
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124126966
- **Authorized official:** CRISTIANA MAURICIO (MGR PHCY ENROLLMENTS)
- **Authorized official phone:** (401) 770-2937

## Contact information

- **Practice address:** 3200 CATON FARM, JOLIET, IL 60431
- **Practice address phone:** (815) 267-8130
- **Mailing address:** 1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 54016010 | IL | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 10/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1479838 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |