Organization
HOLIDAY CVS, L.L.C.
Active
Other names
CVS Pharmacy #05401
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
700 NE 6TH AVE, DELRAY BEACH, FL 33483-5702
(561) 276-5957
Mailing address
1 CVS DR, BOX 1075 -PHARMACY ENROLLMENTS, 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
—
001808700
—
FL
01
—
1051476
NCPDP
—
Enumeration date
12/11/2009
Last updated
09/27/2011
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