# HIGHLAND PARK CVS, L.L.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SCHNUCK MARKETS INC
- **Other names:** CVS Pharmacy \#18077, SCHNUCKS PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467488718
- **Legal business name:** SCHNUCK MARKETS INC
- **Authorized official:** SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 1701 E EMPIRE ST, SUITE 210, BLOOMINGTON, IL 61704-3532
- **Practice address phone:** (309) 662-7004
- **Practice address fax:** (309) 662-6650
- **Mailing address:** 1 CVS DR \# 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WD0400X | Diabetes Educator Registered Nurse | — | NULL | — |
| 163WD0400X | Diabetes Educator Registered Nurse | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 054009806 | IL | — |
| 333600000X | Pharmacy | 054009806 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 07/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1458377 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 430726776706 | — | IL |