Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03642
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
7030 JOG RD, LAKE WORTH, FL 33467-7607
(561) 967-3311
(561) 642-9471
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
20348
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053634
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105593300
—
FL
Enumeration date
09/12/2006
Last updated
07/11/2012
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