Organization

Holiday Cvs Llc

May also be knows as Cvs Pharmacy #05157

Pharmacy in Port Saint Lucie, FL(View on Map)

Legal Business Name

Holiday Cvs Llc

Also Known As

Cvs Pharmacy #05157

NPI Number

1124125612

NPI Type

Organization

Enumeration Date

09/19/2006

Specialties

(Taxonomies)

Code

333600000X
3336C0003X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

20592

Contact
Information

Purpose

Mailing
Location

Address

1 CVS DR
1300 SW ST LUCIE BLVD

City

Woonsocket
Port Saint Lucie

State

RI
FL

Postal Code

02895-6146
34986

Country

US
US

Telephone Number

N/A
(772) 878-7078

Authorized Official

Name

Susan Colbert

Title or Position

DIRECTOR

Telephone Number

(401) 765-1500

Identifiers

Identifier

1080439
106175500

Identifier State

Unknown
FL

Identifier Issuer

OTHER ID NUMBER-COMMERCIAL NUMBER
Unknown

Health Information Exchange

Endpoint Type

CONNECT

Endpoint

https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service

Endpoint Description

2.16.840.1.113883.3.667.2

Use

Other

Content Type

Unknown

Affiliation

Y

Endpoint Location

ABILITY Network100 N 6th St Ste 900AMinneapolis, MN554031516US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/17/2023

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