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Organization

HOLIDAY CVS LLC

Active
Other names
CVS PHARMACY 00406
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization

Contact information

Practice address
2400 TAMIAMI TRL, PUNTA GORDA, FL 33950-5928
(941) 639-1144
(941) 639-7408
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
20672
FL
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1004528
OTHER ID NUMBER-COMMERCIAL NUMBER
05
105629800
FL
01
P00813911
MEDICARE RR
Enumeration date
09/12/2006
Last updated
01/10/2023
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