Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY #03399
Organization subpart
No
Provider details
NPI number
Authorized official
SUE COLBERT (DIRECTOR, MANAGED CARE)
(401) 770-2751
Entity
Organization
Contact information
Practice address
6105 US HIGHWAY 98 N, LAKELAND, FL 33809-6223
(863) 858-4441
(863) 859-2392
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
20251
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040675
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
105850900
—
FL
Enumeration date
09/12/2006
Last updated
11/16/2012
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