Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 05171
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1005 OHIO AVE S, LIVE OAK, FL 32064-4129
(386) 362-5183
(386) 362-4887
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
FL
333600000X
Pharmacy
Primary
20700
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105942400
—
FL
01
—
1079169
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
11/21/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us