Organization
HIGHLAND PARK CVS LLC
Active
Other names
CVS Pharmacy #11376
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1034 WEST LAKE ST, CHICAGO, IL 60607
(312) 705-2004
Mailing address
1 CVS DR # 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
08/28/2019
Last updated
10/02/2019
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