Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03119
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
131 N CONGRESS AVE, BOYNTON BEACH, FL 33426-4209
(561) 734-2666
(561) 734-7790
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
20350
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026980
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105790100
—
FL
Enumeration date
09/12/2006
Last updated
07/23/2012
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