Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #03758
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (PHCY ENROLLMENTS REP)
(401) 770-2751
Entity
Organization
Contact information
Practice address
9204 CORTEZ BLVD, WEEKI WACHEE, FL 34613-6371
(352) 596-1446
(352) 597-0375
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
20585
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105805300
—
FL
01
—
1059117
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
09/23/2011
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