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Organization

HOLIDAY CVS LLC

Active
Other names
CVS PHARMACY 03923
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization

Contact information

Practice address
11060 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32257-1158
(904) 268-7751
(904) 886-0090
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
20691
FL
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105675100
FL
01
1065134
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
09/19/2006
Last updated
09/24/2012
About Stedi
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