Organization
HIGHLAND PARK CVS LLC
Active
Other names
CVS PHARMACY #10951
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
3319 NAMEOKI ROAD, GRANITE CITY, IL 62040-3708
(618) 452-1198
Mailing address
ONE CVS DRIVE, BOX 1075, WONNSOCKET, 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
—
1492658
NCPDP
IL
Enumeration date
05/23/2016
Last updated
11/18/2016
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