Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 00411
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
500 S 11TH ST, LAKE WALES, FL 33853-4901
(863) 676-2564
(863) 678-1353
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
20675
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004530
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105631000
—
FL
Enumeration date
09/12/2006
Last updated
01/10/2023
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