Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS Pharmacy #10737
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DR. PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
222 S HARLEM AVE US RT. 50, PEOTONE, IL 60468
(708) 258-6811
(708) 258-0468
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
20300671
IL
333600000X
Pharmacy
Primary
054.020476
IL
3336C0003X
Community/Retail Pharmacy
054-013264
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054-013264
PHARMACY LIC
IL
01
—
14-05996
NABP
—
05
—
363484164006
—
IL
Enumeration date
10/26/2006
Last updated
11/15/2017
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