Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #03245
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (EXEC DIR, RX SERVICES)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4684 HIGHWAY 90, MARIANNA, FL 32446
(850) 526-3784
(850) 526-5802
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
20717
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033581
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
106002300
—
FL
01
—
P00754232
MEDICARE RR
—
Enumeration date
09/12/2006
Last updated
01/11/2023
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