Organization
HIGHLAND PARK CVS LLC
Active
Other names
CVS Pharmacy #08946
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4186 IL ROUTE 83 BLDG D, LONG GROVE, IL 60047-9563
(847) 478-5465
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1485160
NCPDP
IL
Enumeration date
12/09/2010
Last updated
05/31/2011
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