Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #03818
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
21140 ST ANDREWS BLVD, BOCA RATON, FL 33433-2404
(561) 391-9613
(561) 347-9372
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
20577
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055311
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105815100
—
FL
Enumeration date
09/14/2006
Last updated
04/07/2015
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