Organization
HOLIDAY CVS LLC
Active
Other names
Navarro Discount Pharmacy #10722
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR,PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
366 EAST 4TH AVENUE, HIALEAH, FL 33010-4998
(305) 749-5353
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
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
—
012835200
—
FL
05
—
012835201
—
FL
01
—
1030218
NCPDP
FL
Enumeration date
11/07/2007
Last updated
02/01/2021
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