Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY 03675
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANF F COLBERT (DIRECTOR PHCY ENROLLMENTS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1 E NINE MILE RD, PENSACOLA, FL 32534-3136
(850) 475-1000
(850) 473-9633
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
20427
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052644
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105766900
—
FL
Enumeration date
09/12/2006
Last updated
10/30/2012
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