Cvs Pharmacy #10674
LBN: Highland Park Cvs, L.L.C.
Cvs Pharmacy #10674 is an health care organization with primary practice located at 245 S Broadway Street , Coal City IL 60416. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Highland Park Cvs, L.L.C. can be contacted via phone (815) 634-0455, or through Colbert, Susan via phone (401) 770-2751.
Contact Information
Primary practice address
245 S Broadway Street
Coal City IL 60416
Phone: (815) 634-0455
Fax: (815) 421-0245
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 203000674 | Illinois |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 054-014757 | Illinois |
Profile Details
| NPI number | 1437235447 |
|---|---|
| LBN Legal business name | Highland Park Cvs, L.L.C. |
| DBA Doing business as | Cvs Pharmacy #10674 |
| Authorized official | Colbert, Susan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 31st, 2006 |
| Last updated | Jun 16th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437235447 | NPPES |
| Other | 14-75068 | NABP | |
| MEDICAID | 363484164021 | NABP | |
| Other | 054-014757 | NABP |
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