Organization
HOLIDAY CVS LLC
Active
Other names
CVS Pharmacy #10646
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2962 AVENTURA BLVD, AVENTURA, FL 33180-3103
(401) 765-1500
Mailing address
1 CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5736220
NCPDP
FL
Enumeration date
11/28/2017
Last updated
11/29/2017
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