Highland Park CVS, L.L.C.
Organization Active NPI Community/Retail Pharmacy · Henry, IL
NPI 1508941667 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1508941667
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 054-014136 (IL)
- Legal business name
- HIGHLAND PARK CVS, L.L.C.
- Practice address
- 808 University Avenue
Henry, IL 61537 - Phone
- (309) 364-4320
- Fax
- (309) 364-4353
- NPI assigned
- Oct 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Sr. Dr. Payer Relations
- Phone
- (401) 770-2751
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Highland Park CVS LLC |
Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080103000235 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 2860572856 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 203000675 | IL | |
| Community/Retail Pharmacy | 3336C0003X | 054-014136 | IL | Yes |
Addresses
Primary practice location
808 University Avenue
Henry, IL 61537
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054-014136 | Other | IL | PHARMACY LIC |
| 14-70258 | Other | NABP | |
| 363484164013 | Medicaid | IL |
Other names
- CVS Pharmacy #10656
Other providers in Henry, IL
- Heartland of Henry Il, LLC
- Betty Louise Heinold
- Henry Community Ambulance Service
- Henry Rehab and Nursing LLC
- Henry Senachwine Cusd 5
- Julia Rackley Perry Memorial Hospital
- Julia Rackley Perry Memorial Hospital
- Richard Paul June
- Katherine Marie Lowery
- Luckey Chiropractic Center Inc.
All providers in Henry, IL · Community/Retail Pharmacy in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.