Organization
HIGHLAND PARK CVS LLC
Active
Other names
CVS PHARMACY #05887
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1111 N DUNLAP AVE, SAVOY, IL 61874-9604
(217) 351-2123
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
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
—
1487568
NCPDP
IL
Enumeration date
12/06/2012
Last updated
01/09/2014
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