HIGHLAND PARK CVS, L.L.C. (NPI# 1649373317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649373317 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS, L.L.C. |
| Other Organization Name | CVS PHARMACY 06455 |
| Practice Address |
1200 W Main St Peoria IL 61606-1200 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 3096736272 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-03-08 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| Authorized Official Telephone | 4017651500 |
| 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 |
Suppliers | ||
| Y | 333600000X | Pharmacy | 054-011786 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1458480 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY 06455 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260552 | Highland Park Cvs, L.L.C. | Registered Nurse | 800 Carlyle Ave, Belleville, IL 62221-5509 | 2018-09-27 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1326598319 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1346 E 53rd St., Chicago, IL 60615 | 2016-10-13 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1871047423 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1500 Lincoln Highway, St Charles, IL 60734-3579 | 2016-08-12 |
| 1134576804 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 2000 S Naperville Rd, Wheaton, IL 60189-8153 | 2016-05-23 |
| 1235503517 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3900 W Elm St, Mchenry, IL 60050-4362 | 2015-11-24 |
| 1255698189 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 2239 E Cook St Ste 101, Springfield, IL 62703-1944 | 2012-04-17 |
| 1144540725 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 100 S Fell Ave, Suite 103, Normal, IL 61761 | 2010-06-07 |
| 1396062824 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 10420 Grand Ave, Franklin Park, IL 60131-2209 | 2010-04-23 |
| Street Address |
1200 W MAIN ST |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306461637 | Kristin M Fouts | Pharmacist | 1200 W Main St, Peoria, IL 61606-1200 | 2020-06-12 |
| 1790072924 | Nicole M. Jensen | Optometrist | 1200 W Main St, Ste 21, Peoria, IL 61606-1200 | 2011-07-08 |
| 1760421317 | Jak Enterprises Inc | Optometrist | 1200 W Main St, Suite 21, Peoria, IL 61606-1253 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1215575824 | Maricopa County Special Health Care District | Pharmacy | 8088 W Whitney Dr, Peoria, AZ 85345 | 2019-12-13 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1942756812 | Smiths Food & Drug Centers Inc | Pharmacy | 25401 N Lake Pleasant Pkwy, Peoria, AZ 85383-1351 | 2016-08-30 |
| 1003235144 | Pharmatek Pharmacy Inc | Pharmacy | 10995 N 99th Ave, Suite 112, Peoria, AZ 85345-5405 | 2014-04-15 |
| 1700014446 | Extended Pharmacy LLC | Pharmacy | 121 State St Ste 1a, Peoria, IL 61602-1547 | 2009-07-01 |
| 1922249127 | Potters House Apothecary Inc | Pharmacy | 21585 N 77th Ave, Ste 1500, Peoria, AZ 85382 | 2009-03-18 |
| 1508004144 | Desert Sky Pharmacy, LLC | Pharmacy | 6750 W Thunderbird Rd Ste 103, Peoria, AZ 85381-5046 | 2009-02-03 |
| 1093883290 | Dolan Central Illinois Compounding LLC | Pharmacy | 5832 N Knoxville Ave Ste E, Peoria, IL 61614-4304 | 2006-12-04 |
| 1598853194 | Bashas Inc | Pharmacy | 7586 W Thunderbird Rd, Peoria, AZ 85381-6077 | 2006-10-10 |
| Find all providers in PEORIA | ||||
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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.