Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS Pharmacy # 08910
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
205 N. COLUMBUS, CHICAGO, IL 60601
(312) 861-0315
Mailing address
ONE CVS DRIVE, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
—
1483128
NCPDP
IL
Enumeration date
03/25/2009
Last updated
12/22/2010
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