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NPI Code Detail

MEDICARE: HOLIDAY CVS LLC

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
13336C0003XCommunity/Retail Pharmacy
2333600000XPharmacy20733FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11005710OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932203817
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLIDAY CVS LLC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : PO BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1708 N MONROE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-5535
Country : US
Telephone Number : 850-385-6136
Fax Number : 850-385-0584
Authorized Official
Title or Position : DIRECTOR
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-765-1500
Provider Enumeration Date : 09/12/2006
Last Update Date : 11/05/2012

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Directions to “HOLIDAY CVS LLC ” Practice Location

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