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Organization
HIGHLAND PARK CVS, L.L.C.
Active
Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS Pharmacy 04857
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
570 N FAIRVIEW AVE, DECATUR, IL 62522-1966
(217) 422-1570
(217) 422-2368
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1484334
NCPDP
—
Enumeration date
04/23/2010
Last updated
03/08/2012
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