Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS Pharmacy #10738
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DR. PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1034 W. REYNOLDS STREET, PONTIAC, IL 61764
(815) 842-6774
(815) 842-2648
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
203000699
IL
3336C0003X
Community/Retail Pharmacy
Primary
054-008366
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054-008366
PHARMACY LIC
IL
01
—
14-48794
NABP
—
05
—
363484164017
—
IL
Enumeration date
10/26/2006
Last updated
07/21/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up