Organization Name: | HIGHLAND PARK CVS, L.L.C. |
NPI Number: | 1588895494 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN COLBERT (DIRECTOR, MANAGED CARE CONTRACT ADM) |
Mailing Address: | 7139 N Milwaukee Ave Niles |
State: | IL US |
Postal Code: | 607144424 |
Phone Number: | 8476476422 |
Fax Number: | 8476476520 |
NPI Enumeration Date: | 07/28/2009 |
NPI Last Update Date: | 12/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |