# 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 \#18033
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558397802
- **Legal business name:** SCHNUCK MARKETS INC
- **Authorized official:** SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 1615 CAMP JACKSON RD, CAHOKIA, IL 62206-2539
- **Practice address phone:** (618) 332-0676
- **Practice address fax:** (618) 332-0677
- **Mailing address:** 1 CVS DRIVE, BOX 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 | 054009103 | IL | — |
| 333600000X | Pharmacy | 054009103 | IL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/25/2006
- **Last updated:** 07/15/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1453985 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 430726776148 | — | IL |