Cvs Pharmacy #05917
LBN: Holiday Cvs Llc
Cvs Pharmacy #05917 is an health care organization with primary practice located at 3771 S Clyde Morris Blvd , Port Orange FL 32129-2319. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Holiday Cvs Llc can be contacted via phone (386) 763-4850, or through Colbert, Susan via phone (401) 770-2751.
Contact Information
Primary practice address
3771 S Clyde Morris Blvd
Port Orange FL 32129-2319
Phone: (386) 763-4850
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | PH202023 | Florida |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1184728164 |
|---|---|
| LBN Legal business name | Holiday Cvs Llc |
| DBA Doing business as | Cvs Pharmacy #05917 |
| Authorized official | Colbert, Susan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Dec 11th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184728164 | NPPES |
| Florida | MEDICAID | 026791100 | |
| Florida | Other | 1003603 |
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