Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #03441
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONSQ)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2331 PALM RIDGE RD, SANIBEL, FL 33957-3204
(239) 472-1719
(239) 472-6091
Mailing address
1 CVS DR, PO 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
20386
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045512
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105863100
—
FL
01
—
P00754232
MEDICARE RR
—
Enumeration date
09/12/2006
Last updated
09/11/2012
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