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
1	3336C0003X	Community/Retail Pharmacy	054-013264	IL
2	332B00000X	Durable Medical Equipment & Medical Supplies	20300671	IL
3	333600000X	Pharmacy	054.020476	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	054-013264	OTHER	IL	PHARMACY LIC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	14-05996	OTHER		NABP

General Provider Information

NPI Number	:	1730264748
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	:
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:	401-770-7108

Provider Business Practice Location Address
First Line	:	222 S HARLEM AVE US RT. 50
Second Line	:
City	:	PEOTONE
State	:	IL
Zip	:	60468
Country	:	US
Telephone Number	:	708-258-6811
Fax Number	:	708-258-0468

Authorized Official
Title or Position	:	SR. DR. PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	11/15/2017

Similar Medicare Providers

1528061538 — PETER J. MARCH D.D.S.
Practice Location Address:

517 S GOVERNORS HWY
PEOTONE, IL
60468-9115

Practice Phone: 708-258-6281
Practice Fax:

1083713978 — DR. MICHAEL C HYRE MD
Practice Location Address:

611 S DIVISION ST
PEOTONE, IL
60468-9590

Practice Phone: 708-258-9058
Practice Fax: 708-258-0421

1952401572 — DR. BRENDA SUE TESKE D.C.
Practice Location Address:

425 S GOVERNORS HWY
PEOTONE, IL
60468-9116

Practice Phone: 708-258-3965
Practice Fax: 708-258-6640

1669553517 — HOME MEDICAL SUPPLIES INC
Practice Location Address:

422 SOUTH GOVERNORS HIGHWAY , SUITE 15
PEOTONE, IL
60468-9113

Practice Phone: 708-259-9880
Practice Fax: 708-258-9888

1740346451 — RIVERSIDE MEDICAL CENTER
Practice Location Address:

611 DIVISION STREET
PEOTONE, IL
60468-9590

Practice Phone: 815-935-3272
Practice Fax: 815-937-7961

1346391976 — DR. KEITH PETER WILSON DDS
Practice Location Address:

211 N SECOND ST , PO 727
PEOTONE, IL
60468-8837

Practice Phone: 708-258-3331
Practice Fax:

Directions to “HIGHLAND PARK CVS, L.L.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.