HIGHLAND PARK CVS LLC (NPI# 1124040837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124040837 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS LLC |
| Other Organization Name | CVS PHARMACY #17068 |
| Practice Address |
355 W Mound Rd Decatur IL 62526-1965 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2178756550 |
| Practice Fax Number | 2173305380 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-08-29 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054.019768 | IL | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2021770 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17068 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972116499 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 4631 W Foster Ave, Chicago, IL 60630 | 2020-08-25 |
| 1558974071 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 W Webster Ave, Chicago, IL 60614-7610 | 2020-08-25 |
| 1669002135 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 2434 N Sacramento Ave, Chicago, IL 60647-2666 | 2020-01-23 |
| 1215585757 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1034 West Lake St, Chicago, IL 60607 | 2019-08-28 |
| 1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
| 1316428147 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 739 Roosevelt Rd, Glen Ellyn, IL 60137-5877 | 2018-08-29 |
| 1124520424 | Highland Park Cvs LLC | Pharmacy | 110 E Norris Dr, Ottawa, IL 61350-1515 | 2018-03-02 |
| 1326555236 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 678 N Wells St, Chicago, IL 60654-3717 | 2018-01-02 |
| 1174040687 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 3300 N Ashland Ave, Chicago, IL 60657-2109 | 2017-08-25 |
| 1538686357 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1129 Lake St., Oak Park, IL 60301 | 2017-08-23 |
| Street Address |
355 W MOUND RD |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-1965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558612184 | Samantha Elizabeth Feriozzi | Pharmacist | 355 W Mound Rd, Decatur, IL 62526-1965 | 2012-09-22 |
| 1700173747 | Sarah E. Hackney | Pharmacist | 355 W Mound Rd, T-1951, Decatur, IL 62526-1965 | 2011-06-28 |
| 1801181953 | Christopher M Nelson | Pharmacist | 355 W Mound Rd, Target T-1951, Decatur, IL 62526-1965 | 2011-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
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| 1093108805 | Solaris Pharmacy | Pharmacy | 1308 E Old Chico Rd, Decatur, TX 76234-3405 | 2015-03-18 |
| 1306243605 | Rxmtm Consultants LLC | Pharmacy | 3164 Glenwood Rd, Decatur, GA 30032-4155 | 2014-12-02 |
| 1952704892 | Wal-mart Stores Inc | Pharmacy | 154 E Roller Ave, Decatur, AR 72722-9446 | 2014-10-07 |
| 1528495660 | National Prescription | Pharmacy | 2107 N Decatur Rd Ste 190, Decatur, GA 30033-5305 | 2013-10-03 |
| 1760723878 | Gfpi L.L.C. - Guice Pharmacy | Pharmacy | 1416 6th Ave Se Unit D, Decatur, AL 35601-4247 | 2013-03-14 |
| 1851666069 | Sondial Pharmacy, LLC | Pharmacy | 1428 Scott Blvd Ste C, Decatur, GA 30030-1424 | 2012-03-21 |
| 1295045573 | Genoa Healthcare, LLC | Pharmacy | 151 N Main St Rm 332, Decatur, IL 62523-1206 | 2010-10-20 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.