Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03198
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PHCY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
175 STATE ROAD 312 W, ST AUGUSTINE, FL 32086-4201
(904) 824-6167
(904) 824-2015
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
20646
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032402
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105572100
—
FL
Enumeration date
09/12/2006
Last updated
09/24/2012
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