Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY# 10078
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2101 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-3723
(954) 457-4949
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015768000
—
FL
01
—
5727714
NCPDP
—
Enumeration date
08/27/2015
Last updated
02/11/2016
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