Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03960
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C3 (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
3765 ULMERTON RD, CLEARWATER, FL 33762-4209
(727) 573-3383
(727) 572-5716
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
20663
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105696400
—
FL
01
—
1064485
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
10/15/2010
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