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Organization

HIGHLAND PARK CVS, L.L.C.

Active
Parent organization
SCHNUCK MARKETS INC
Other names
CVS Pharmacy #18066
Organization subpart
Yes

Provider details

NPI number
Legal business name
SCHNUCK MARKETS INC
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization

Contact information

Practice address
2712 GODFREY RD, GODFREY, IL 62035-3311
(618) 466-0825
(618) 467-0544
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
332B00000X
Durable Medical Equipment & Medical Supplies
05412051
IL
333600000X
Pharmacy
05412051
IL
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1465853
OTHER ID NUMBER-COMMERCIAL NUMBER
05
430726776269
IL
Enumeration date
06/25/2006
Last updated
07/15/2020
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