Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03664
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1010 BLOOMINGDALE AVE, VALRICO, FL 33596-6105
(813) 684-0283
(813) 661-8532
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
20344
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1054915
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
106043100
—
FL
Enumeration date
09/12/2006
Last updated
09/23/2011
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