Organization
HIGHLAND PARK CVS, L.L.C
Active
Other names
CVS PHARMACY #17683
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
2650 N CLARK ST, CHICAGO, IL 60614-1523
(773) 525-0179
Mailing address
ONE CVS DRIVE, WOONSOCKET, RI 02895
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IL
333600000X
Pharmacy
Primary
—
IL
3336C0003X
Community/Retail Pharmacy
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1492494
NCPDP
IL
Enumeration date
06/08/2016
Last updated
10/26/2016
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