Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 04357
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
283 SW BAYA DR, LAKE CITY, FL 32025-5227
(386) 755-2770
(904) 755-4261
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
—
FL
333600000X
Pharmacy
Primary
20752
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105552600
—
FL
01
—
1064839
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
11/15/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us