Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #00139
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6820 GULFPORT BLVD S, SOUTH PASADENA, FL 33707-2108
(727) 345-9103
(727) 347-1844
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
20581
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004249
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105496100
—
FL
Enumeration date
09/12/2006
Last updated
10/23/2015
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