Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY# 08937
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
24450 SR 44, EUSTIS, FL 32736-9349
(352) 357-2576
Mailing address
1 CVS DR, BOX 1075-PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
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
05
—
000713800
—
FL
01
—
000713801
DME
FL
01
—
1041487
NCPDP
—
Enumeration date
01/15/2009
Last updated
11/03/2010
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