Organization
HOLIDAY CVS LLC
Active
Other names
CVS PHARMACY# 02030
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
301 S. 6TH AVE, WAUCHULA, FL 33873
(863) 767-1195
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
—
032603800
—
FL
01
—
032603801
FL DME
FL
01
—
1033036
NCPDP
—
Enumeration date
03/04/2008
Last updated
11/06/2012
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