Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162) — for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1063454254
Highland Park Cvs Llc
Organization Subpart: NO
Active
NPI Number1063454254
NPI TypeNPI-2 Organization
SpecialtyPharmacy
Provider Details
NPI1063454254
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-06-12
Last Updated2023-01-19
Authorized OfficialSusan Colbert
Director
Phone: 4017651500
Mailing Address1 Cvs Dr, Po Box 1075
Woonsocket, RI 02895-6146
United States
📍 View Map
Primary Practice Address1316 Charleston Ave
Mattoon, IL 61938-4016
United States
Phone: (217) 258-2920
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)1479131Other ID Number-Commercial Number
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies
No3336C0003X – Pharmacy, Community/Retail Pharmacy
Yes333600000X – Pharmacy
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About NPI 1063454254

Highland Park Cvs Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1063454254. The primary specialty listed is Pharmacy. The organization is located in Mattoon, IL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1063454254?

NPI 1063454254 belongs to Highland Park Cvs Llc, a Pharmacy in Mattoon, IL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1063454254 active?

The current status of NPI 1063454254 in the NPPES registry is Active. The record was last updated on 2023-01-19.

What specialty is NPI 1063454254?

NPI 1063454254 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1063454254?

You can verify NPI 1063454254 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1063454254?

The primary practice address on file for NPI 1063454254 is 1316 Charleston Ave, Mattoon, IL 61938-4016. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1063454254 issued?

NPI 1063454254 was first issued (enumerated) on 2006-06-12. The NPPES record was last updated on 2023-01-19.

Practice Location Map

Highland Park Cvs Llc is located at 1316 Charleston Ave, Mattoon, IL. Use the map below to find directions or verify the practice location.

📍 1316 Charleston Ave, Mattoon, IL 61938-4016  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Highland Park Cvs Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-17 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162