Highland Park Cvs, L.L.C.
Pharmacy in Jacksonville, IL. Organization (NPI-2).
NPI number1497993232
StatusActive
Last updated in NPPESOct 8, 2014
Details
- NPI
- 1497993232
- Entity type
- Organization (NPI-2)
- Legal business name
- Highland Park Cvs, L.L.C.
- Organization subpart
- No
- Enumeration date
- Feb 2, 2009
- Last updated
- Oct 8, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | – | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | IL | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | IL |
Other names
- Cvs Pharmacy # 02692 (Doing Business As)
Practice location
936 S. Main St.Jacksonville, IL 62650-3014
Phone 401-765-1500
Mailing address
One Cvs DriveBox 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone 401-765-1500
Authorized official
Susan Colbert
Director, Payer Relations
4017702751
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