Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS Pharmacy #18085
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
915 W MAIN ST, CARBONDALE, IL 62901-2330
(618) 351-0710
(618) 351-0602
Mailing address
1 CVS DR, BOX 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
054013657
IL
333600000X
Pharmacy
054013657
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467821
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
430726776722
—
IL
Enumeration date
06/25/2006
Last updated
07/15/2020
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