Organization
HOLIDAY CVS LLC
Active
Other names
CVS Pharmacy #17786
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1906 PONCE DE LEON BOULVARD, CORAL GABLES, FL 33134
(305) 459-7202
Mailing address
1 CVS DR, 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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5743516
NCPDP
FL
Enumeration date
01/07/2020
Last updated
02/12/2020
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