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Organization

HOLIDAY CVS, L.L.C.

Active
Other names
CVS Pharmacy # 05400
Organization subpart
No

Provider details

NPI number
Authorized official
SUE COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization

Contact information

Practice address
6790 CENTRAL FLORIDA PKWY, ORLANDO, FL 32821-6025
(407) 238-4726
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
001842000
FL
01
001842001
DME
FL
01
1051452
NCPDP
Enumeration date
12/11/2009
Last updated
10/25/2010
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