Organization
HOLIDAY CVS, L.L.C.
Active
Other names
CVS Pharmacy # 05823
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5310 45TH STREET EAST, BRADENTON, FL 34203
(941) 751-4472
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PH22353
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031778100
—
FL
Enumeration date
11/08/2006
Last updated
09/26/2011
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