Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #03204
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5010 S FLORIDA AVE, LAKELAND, FL 33813-2510
(863) 644-2411
(863) 648-4696
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
20556
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034090
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105574700
—
FL
Enumeration date
09/12/2006
Last updated
08/23/2012
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