Organization · NPI-2

Holiday Cvs LLC

Pharmacy · Port Saint Lucie, FL

NPI number1124125612
StatusActive
Last updated in NPPESJan 17, 2023

Details

NPI
1124125612
Entity type
Organization (NPI-2)
Legal business name
Holiday Cvs LLC
Organization subpart
No
Enumeration date
Sep 19, 2006
Certification date
Jan 17, 2023
Last updated
Jan 17, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
333600000X Pharmacy20592FLYes
3336C0003X Pharmacy, Community/Retail Pharmacy––

Other names

  • Cvs Pharmacy #05157 (Doing Business As)

Practice location

1300 Sw St Lucie Blvd
Port Saint Lucie, FL 34986

Phone 772-878-7078 · Fax 772-343-0608

Mailing address

1 Cvs Dr
Po Box 1075
Woonsocket, RI 02895-6146

Authorized official

Susan Colbert
Director
4017651500

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