Organization
HOLIDAY CVS LLC
Active
Other names
Navarro Discount Pharmacy #10724
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR DIRECTOR,PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2614 NE 10TH CT, HOMESTEAD, FL 33033-4712
(305) 242-0377
(305) 242-0410
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
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012832500
—
FL
05
—
012832501
—
FL
01
—
5707952
NCPDP
—
Enumeration date
10/13/2011
Last updated
07/09/2015
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