Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #04041
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
9801 S US HIGHWAY 1, PORT SAINT LUCIE, FL 34952-5628
(772) 337-2553
(772) 335-7460
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
20676
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105711100
—
FL
01
—
1070767
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
03/19/2012
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