Organization
HIGHLAND PARK CVS, L.L.C
Active
Other names
Schnucks Pharmacy, CVS Pharmacy #18092
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
10405 N CENTERWAY DR, PEORIA, IL 61615-1233
(309) 621-7342
(309) 621-7343
Mailing address
1 CVS DRIVE, 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
—
—
333600000X
Pharmacy
054020076
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165835
PK
—
Enumeration date
10/26/2016
Last updated
07/14/2020
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