Organization
HOLIDAY CVS LLC
Active
Other names
CVS Pharmacy #16177
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
444 MONUMENT RD, JACKSONVILLE, FL 32225-6429
(904) 722-8573
(904) 271-2355
Mailing address
1 CVS DR, BOX 1075, 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
PH 29862
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014210
PK
—
Enumeration date
07/24/2006
Last updated
09/22/2016
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