Organization
HIGHLAND PARK CVS, L.L.C.
Active
Parent organization
SCHNUCK MARKETS INC
Other names
CVS Pharmacy #18038
Organization subpart
Yes
Provider details
NPI number
Legal business name
SCHNUCK MARKETS INC
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
907 E US HIGHWAY 50, O FALLON, IL 62269-2856
(618) 632-5525
(618) 632-0729
Mailing address
1 CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(314) 994-4586
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
54013333
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467275
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
431394080001
—
IL
Enumeration date
11/07/2006
Last updated
07/15/2020
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