Organization
HIGHLAND PARK CVS LLC
Active
Other names
CVS Pharmacy #17175
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4120 W 95TH ST, OAK LAWN, IL 60453-2675
(708) 741-4070
(708) 741-4069
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
054.019766
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023286
PK
—
Enumeration date
01/11/2007
Last updated
08/29/2016
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