NPIMap

Organization Active NPI

Highland Park CVS LLC

  • Pharmacy
  • Melrose Park, IL
National Provider Identifier
1912929704
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
HIGHLAND PARK CVS LLC
Practice address
850 W North Ave
Melrose Park, IL 60160-1611
Phone
(708) 338-2795
Fax
(708) 338-2795
NPI assigned
Jul 24, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Highland Park CVS LLC850 W North Ave, Melrose Park, IL 60160-1611(708) 338-2795 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 assignmentParticipating since Jan 1, 2023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20080103000235 IL Part B Supplier - Mass Immunization (Roster Biller Only) 2860572856 This NPI is an additional NPI on the enrollment
O20160727001073 IL DME Supplier - Pharmacy 2860572856 Practice locations: Melrose Park, IL

National Provider Directory

National Provider Directory
Tax ID family
Highland Park CVS LLC (309 organizations share this tax ID)

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X 054.019707 IL

Addresses

NPPES NPI Registry

Primary practice location

850 W North Ave
Melrose Park, IL 60160-1611

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
2021721OtherPK

Other names 1

NPPES NPI Registry
  • CVS Pharmacy #16281 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2016.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1912929704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601611",
            "telephone_number": "708-338-2795",
            "fax_number": "708-338-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PARK CVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.019707",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2021721",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #16281",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.