Organization
HIGHLAND PARK CVS, L.L.C.
Active
Other names
CVS Pharmacy # 08926
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
983 IL ROUTE 59, ANTIOCH, IL 60002-1453
(847) 395-5691
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
—
IL
333600000X
Pharmacy
Primary
—
IL
3336C0003X
Community/Retail Pharmacy
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1483382
NCPDP
IL
Enumeration date
06/03/2009
Last updated
10/20/2014
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