Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03519
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
238 US HIGHWAY 17, EAST PALATKA, FL 32131-6059
(386) 328-6713
(904) 329-5254
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
—
—
333600000X
Pharmacy
Primary
20632
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041920
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105636100
—
FL
Enumeration date
09/14/2006
Last updated
11/16/2012
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