Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
SCHNUCKS PHARMACY, CVS Pharmacy #18098
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2642 CHARLES ST, ROCKFORD, IL 61108-1671
(815) 484-2461
(815) 484-2462
Mailing address
1 CVS DR # 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
054014238
IL
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054014238
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1471464
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
430726776754
—
IL
Enumeration date
12/11/2006
Last updated
07/14/2020
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