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NPI Code Detail

MEDICARE: HIGHLAND PARK CVS, L.L.C.

MEDICARE: HIGHLAND PARK CVS, L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

General Provider Information

NPI Number : 1407626948
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND PARK CVS, L.L.C.
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895
Country : US
Telephone Number : 401-765-1500
Fax Number :
Provider Business Practice Location Address
First Line : 4728 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2701
Country : US
Telephone Number : 773-628-0043
Fax Number :
Authorized Official
Title or Position : SR. DIRECTOR
Name : SUSAN F COLBERT
Credential :
Telephone Number : 800-746-7287
Provider Enumeration Date : 01/05/2024
Last Update Date : 05/01/2024

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