Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #10131
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2393 SW 67TH AVE, MIAMI, FL 33155-1845
(305) 264-0636
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012200300
—
FL
01
—
5719755
NCPDP
—
Enumeration date
04/15/2014
Last updated
06/03/2015
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