# HIGHLAND PARK CVS, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CVS Pharmacy \#10656
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508941667
- **Authorized official:** SUSAN COLBERT (SR. DR. PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 808 UNIVERSITY AVENUE, HENRY, IL 61537
- **Practice address phone:** (309) 364-4320
- **Practice address fax:** (309) 364-4353
- **Mailing address:** 1 CVS DR, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500
- **Mailing address fax:** (401) 770-7108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 203000675 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | 054-014136 | IL | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 054-014136 | PHARMACY LIC | IL |
| 01 | — | 14-70258 | NABP | — |
| 05 | — | 363484164013 | — | IL |