HIGHLAND PARK CVS LLC (NPI# 1861414674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861414674 |
Entity Type | Organization |
Organization Name | HIGHLAND PARK CVS LLC |
Other Organization Name | CVS PHARMACY #16362 |
Practice Address |
2102 N Prospect Ave Champaign IL 61822-1231 |
Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
Practice Telephone | 2173553345 |
Practice Fax Number | 2173553345 |
Mailing Telephone | 4017651500 |
Enumeration Date | 2006-07-24 |
Last Update Date | 2016-09-23 |
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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054.019762 | IL | Suppliers |
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
Y | 333600000X | Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2023421 | 01 |
Other Name | Type Code |
---|---|
CVS Pharmacy #16362 | 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 |
2102 N PROSPECT AVE |
City | CHAMPAIGN |
State | IL |
Zip Code | 61822-1231 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386096188 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 2102 N Prospect Ave, Champaign, IL 61822-1231 | 2016-07-06 |
1316284367 | Vindha Prasad | Pharmacist | 2102 N Prospect Ave, T-0943, Champaign, IL 61822-1231 | 2013-01-10 |
1083901953 | Brandon Joseph Billman | Pharmacist | 2102 N Prospect Ave, Champaign, IL 61822-1231 | 2011-06-29 |
1467766519 | Carlene Marie Kudrick | Pharmacist | 2102 N Prospect Ave, Champaign, IL 61822-1231 | 2010-07-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
Find all providers in zip 61822 |
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 |
---|---|---|---|---|
1104103290 | Coram Alternate Site Services, Inc. | Pharmacy | 2022 Glen Park Dr, Champaign, IL 61821-2405 | 2011-11-03 |
1871648600 | Carle Foundation Hospital | Pharmacy | 1701 West Curtis Rd, Champaign, IL 61822-9678 | 2007-01-24 |
1467556415 | Lehman's Pharmacy LLC | Pharmacy | 716 S Randolph St Ste A, Champaign, IL 61820-8315 | 2006-09-12 |
1346674280 | Independence Holding Co LLC | Pharmacy | 14 E Washington St Ste C, Champaign, IL 61820-3677 | 2013-08-28 |
1578618914 | Carle Foundation Hospital | Pharmacy | 1757 W Kirby Ave, Champaign, IL 61821-5500 | 2007-01-24 |
1487749560 | Christie Pharmacy Champaign LLC | Pharmacy | 101 W University Ave, Champaign, IL 61820-3909 | 2006-10-04 |
1669499950 | Sams West Inc | Pharmacy | 915 W Marketview Dr, Champaign, IL 61822-1221 | 2006-07-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730702549 | Aster Pharmacy LLC | Pharmacy | 9213 Waukegan Rd, Morton Grove, IL 60053-2102 | 2020-05-27 |
1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
1336768001 | Mhg Pharmacy Services, LLC | Pharmacy | 2923 N California Ave Ste 240, Chicago, IL 60618-7702 | 2020-04-13 |
1184258824 | Metropolitian Austin Outpatient Pharmacy LLC | Pharmacy | 645 S Central Ave Ste 1, Chicago, IL 60644-5059 | 2020-03-02 |
1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
1568093615 | Carefirst Pharmacy, Inc. | Pharmacy | 2253 N Cicero Ave, Chicago, IL 60639-3327 | 2020-01-28 |
1720624521 | Affinity Pharmacy Care LLC | Pharmacy | 285 W Loop Rd Ste 1, Wheaton, IL 60189-2036 | 2019-11-27 |
1104462126 | Loyola University Medical Center | Pharmacy | 2160 S 1st Ave Rm 150-1610, Maywood, IL 60153-3328 | 2019-11-25 |
1346886512 | Value Plus Pharmacy LLC | Pharmacy | 457 W Liberty St, Wauconda, IL 60084-2452 | 2019-11-22 |
1841833100 | April M Bailey | Pharmacy | 1019 Oakcrest Dr, Rantoul, IL 61866-1118 | 2019-10-18 |
Find all providers with the same taxonomy |
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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.