Organization
HOLIDAY CVS L.L.C.
Active
Other names
CVS Pharmacy #05832
Organization subpart
No
Provider details
NPI number
Authorized official
SUE COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1515 NW 13TH ST, GAINESVILLE, FL 32601-4056
(352) 378-6460
Mailing address
ONE CVS DRIVE, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895
(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
—
002006400
—
FL
01
—
002006401
DME
FL
01
—
1053482
NCPDP
—
Enumeration date
02/22/2010
Last updated
09/23/2015
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