Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY# 04485
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
19225 NW US HIGHWAY 441, HIGH SPRINGS, FL 32643-8784
(386) 454-3334
(386) 454-7756
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
20569
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105671900
—
FL
01
—
1065033
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/06/2006
Last updated
04/03/2019
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