Organization
HOLIDAY CVS, L.L.C.
Active
Other names
CVS Pharmacy #04989
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-5721
Entity
Organization
Contact information
Practice address
4500 DONALD ROSS ROAD, PALM BEACH GARDENS, FL 33418
(561) 624-3799
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PH22184
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031673300
—
FL
01
—
1019416
NCPDP
—
Enumeration date
08/11/2006
Last updated
09/27/2011
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