Healthcare Provider Details

I. General information

NPI: 1730514944
Provider Name (Legal Business Name): CPS TELEPHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 W DIEHL RD STE 110
NAPERVILLE IL
60563-4912
US

IV. Provider business mailing address

1 OPTUM CIR STE 100
EDEN PRAIRIE MN
55344-2503
US

V. Phone/Fax

Practice location:
  • Phone: 630-799-1595
  • Fax: 630-596-1649
Mailing address:
  • Phone: 800-328-5979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEVIN EUGENE BURR
Title or Position: SECRETARY
Credential:
Phone: 712-310-4701