Highland Park Cvs LLC
Highland Park Cvs LLC is a healthcare organization registered as Pharmacy in Mattoon, IL, holding Type 2 (organization) NPI 1063454254 since 2006. The authorized official on file is Susan Colbert, Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063454254 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Highland Park Cvs LLC |
| Other name | <Unavail> |
| Practice address | 1316 CHARLESTON AVE, Mattoon, IL, 61938 |
| Phone | 2172582920 |
| Enumeration date | 2006-06-12 |
| Last updated in NPPES | 2023-01-19 |
Authorized official
| Name | Susan Colbert |
|---|---|
| Title | Director |
| Phone | 4017651500 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Secondary | — | — |
| 333600000X | Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1479131 | Other | — | OTHER ID NUMBER-COMMERCIAL NUMBER |
Copy-ready billing details
Provider: Highland Park Cvs LLC NPI: 1063454254 Taxonomy: 333600000X (Pharmacy) Address: 1316 CHARLESTON AVE, Mattoon, IL, 61938
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1982633509 | Tony Richards | Individual | Pharmacist | Mattoon, IL |
| 1033713524 | Jason Waggoner | Individual | Pharmacist | Mattoon, IL |
| 1093301863 | Carissa Runde | Individual | Pharmacist | Mattoon, IL |
Verify this record
Cross-check NPI 1063454254 against the authoritative CMS record: view Highland Park Cvs LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Highland Park Cvs LLC located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-01-19.