Organization

Holiday Cvs Llc

May also be knows as Cvs Pharmacy #04254

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

Legal Business Name

Holiday Cvs Llc

Also Known As

Cvs Pharmacy #04254

NPI Number

1306943899

NPI Type

Organization

Enumeration Date

09/19/2006

Specialties

(Taxonomies)

Code

333600000X
3336C0003X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

20692

Contact
Information

Purpose

Mailing
Location

Address

1 CVS DR
301 NE PRIMA VISTA BLVD

City

Woonsocket
Port Saint Lucie

State

RI
FL

Postal Code

02895-6146
34983

Country

US
US

Telephone Number

(401) 765-1500
(772) 340-3640

Authorized Official

Name

Susan Colbert

Title or Position

DIRECTOR PAYER RELATIONS

Telephone Number

(401) 770-2751

Identifiers

Identifier

105546100
1073826

Identifier State

FL
Unknown

Identifier Issuer

Unknown
OTHER ID NUMBER-COMMERCIAL NUMBER

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

Data last updated by provider on 11/15/2012

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