Organization
HIGHLAND PARK CVS LLC
Active
Other names
CVS PHARMACY # 06927
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
805 S DIXIE HWY, HOOPESTON, IL 60942-1939
(217) 283-7225
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
—
—
333600000X
Pharmacy
Primary
054-011836
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447730
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00754320
MEDICARE RR
—
Enumeration date
09/07/2006
Last updated
04/15/2011
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