Organization
HOLIDAY CVS, L.L.C.
Active
Other names
CVS Pharmacy #03401
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
13199 SW 112TH ST, MIAMI, FL 33186-4600
(305) 382-4161
(305) 388-2045
Mailing address
1 CVS DR, 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
20253
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043140
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105852500
—
FL
Enumeration date
09/12/2006
Last updated
07/11/2024
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