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HIGHLAND PARK CVS L.L.C. NPI 1316178064


NPI Information

NPI: 1316178064
Provider Name: HIGHLAND PARK CVS, L.L.C.

Doing Business As: CVS PHARMACY 07017

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 14D2218212

Address:
1130 S VETERANS PKWY
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 661-1839
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HIGHLAND PARK CVS, L.L.C. is a pharmacy in Bloomington, IL. The provider is 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. HIGHLAND PARK CVS, L.L.C. NPI is 1316178064. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy 07017.

The provider's business location address is:

1130 S VETERANS PKWY
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 661-1839

The provider's authorized official is Susan Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 14D2218212 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2009 and was last updated on 10/15/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1215982MEDICARE PINILLINOIS
24723660112MEDICARE NSC
31483611OTHERNCPDP
4=========033MEDICAIDILLINOIS
5P00959569MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.