HIGHLAND PARK CVS, L.L.C (NPI# 1770035636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770035636 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS, L.L.C |
| Other Organization Name | SCHNUCKS PHARMACY |
| Practice Address |
10405 N Centerway Dr Peoria IL 61615-1233 |
| Mailing Address |
1 Cvs Drive Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 3096217342 |
| Practice Fax Number | 3096217343 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2020-07-14 |
| 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 | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
Nursing Service Providers | ||
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | 054020076 | IL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2165835 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #18092 | Doing Business As Name - Organization |
| Schnucks Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134578354 | Highland Park Cvs, L.l.c | Pharmacy | 2650 N Clark St, Chicago, IL 60614-1523 | 2016-06-08 |
| 1154491884 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 902 E Oak St, Fairbury, IL 61739 | 2006-11-09 |
| 1558446633 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 106 Watters Dr, Dwight, IL 60420 | 2006-10-26 |
| 1649355660 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 1101 S. Water St., Wilmington, IL 60481 | 2006-10-26 |
| 1093819948 | Highland Park Cvs, L.l.c | Pharmacy | 7855 S Western Ave, Chicago, IL 60620-5823 | 2006-09-12 |
| 1497790406 | Highland Park Cvs, L.l.c | Registered Nurse | 4800 N University St, Peoria, IL 61614-5891 | 2006-06-17 |
| Street Address |
10405 N CENTERWAY DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-1233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164908380 | James Hills | Pharmacist | 10405 N Centerway Dr, Peoria, IL 61615-1233 | 2018-07-11 |
| 1407332521 | Gira Raghunandan | Pharmacist | 10405 N Centerway Dr, Peoria, IL 61615-1233 | 2018-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831573021 | Hy Vee Inc | Pharmacy | 7610 N Orange Prairie Road, Peoria, IL 61615 | 2015-07-17 |
| 1184842718 | Harbor Vista | Pharmacy | 9133 W Thunderbird, #102, Peoria, AZ 85381 | 2007-04-20 |
| 1053415943 | German Dobson Cvs, L.L.C. | Pharmacy | 7530 W Cactus Rd, Peoria, AZ 85381-5202 | 2006-09-12 |
| 1750485645 | Cvs 3745 Peoria LLC | Pharmacy | 10727 W Olive Ave, Peoria, AZ 85345-9202 | 2006-09-12 |
| 1831293729 | German Dobson Cvs, L.L.C. | Pharmacy | 8332 W Thunderbird Rd, Peoria, AZ 85381-4822 | 2006-09-12 |
| 1093818866 | Highland Park Cvs, L.L.C. | Pharmacy | 3015 N Sterling Ave, Peoria, IL 61604-2259 | 2006-09-07 |
| 1114020880 | Highland Park Cvs, L.L.C. | Pharmacy | 9315 N Lindbergh Dr, Peoria, IL 61615-1454 | 2006-09-07 |
| 1053350439 | Albertsons LLC | Pharmacy | 7575 W Cactus Rd, Peoria, AZ 85381-5201 | 2006-06-04 |
| 1578513834 | Bogard Drug No. 5, Inc. | Pharmacy | 1102 S Western Ave, Peoria, IL 61605-3356 | 2006-05-10 |
| 1881000339 | Westgaterx Pharmacy | Pharmacy | 8914 N 91st Ave, S 100c, Peoria, AZ 85345-8396 | 2014-07-04 |
| 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.