MEDICARE: HOLIDAY CVS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH 29646	FL
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2008492	OTHER		PK

General Provider Information

NPI Number	:	1154343754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLIDAY CVS LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	BOX 1075
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6331 ROOSEVELT BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-3303
Country	:	US
Telephone Number	:	904-596-1066
Fax Number	:	904-596-1066

Authorized Official
Title or Position	:	SR. DIRECTOR, PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	09/22/2016

Similar Medicare Providers

1376695346 — LUXOTTICA RETAIL NORTH AMERICA INC
Practice Location Address:

6331 ROOSEVELT BLVD
JACKSONVILLE, FL
32244-3303

Practice Phone: 904-596-1068
Practice Fax:

1902959992 — LAUREN KAYE HOWARD
Practice Location Address:

6331 ROOSEVELT BLVD , T-1853
JACKSONVILLE, FL
32244-3303

Practice Phone: 904-596-1066
Practice Fax:

1184918278 — DR. SHANNON CORNING PHARM.D.
Practice Location Address:

6331 ROOSEVELT BLVD , T1853
JACKSONVILLE, FL
32244-3303

Practice Phone: 904-596-1066
Practice Fax: 904-596-1066

1952695769 — DR. JEREMY R PALENIK PHARM.D.
Practice Location Address:

6331 ROOSEVELT BLVD , T-1853
JACKSONVILLE, FL
32244-3303

Practice Phone: 904-596-1066
Practice Fax: 904-596-1066

1053725721 — CHARLES JORDAN GUESS PHARM.D.
Practice Location Address:

6331 ROOSEVELT BLVD
JACKSONVILLE, FL
32244-3303

Practice Phone: 904-596-1066
Practice Fax:

1053914929 — TIFFANY WEISS PHARMD
Practice Location Address:

6331 ROOSEVELT BLVD
JACKSONVILLE, FL
32244-3303

Practice Phone: 904-596-1066
Practice Fax: 904-520-4184

Directions to “HOLIDAY CVS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.