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Contact Information

HIGHLAND PARK CVS, L.L.C.
230 COMET DRIVE
BRAIDWOOD, IL60408
 Phone: 815-458-0642
 Fax: 815-458-3703
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for HIGHLAND PARK CVS, L.L.C.

NPI Number 1437234606
LBN Legal business name HIGHLAND PARK CVS, L.L.C.
Authorized official SUSAN COLBERT - (SR. DR. PAYER RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2006
Last updated 07/21/2022 - About 4 years ago
Identifiers
IL License # 054-009424
IL License # 203000681
IL Medicaid 363484164001
IL Other 054-009424 PHARMACY LIC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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