Cvs Pharmacy # 04112
LBN: Holiday Cvs Llc
Cvs Pharmacy # 04112 is an health care organization with primary practice located at 1816 Dunlawton Ave , Port Orange FL 32127-2921. 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) 322-3919, or through Colbert, Susan via phone (401) 770-2751.
Contact Information
Primary practice address
1816 Dunlawton Ave
Port Orange FL 32127-2921
Phone: (386) 322-3919
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1366741258 |
|---|---|
| LBN Legal business name | Holiday Cvs Llc |
| DBA Doing business as | Cvs Pharmacy # 04112 |
| Authorized official | Colbert, Susan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 18th, 2011 |
| Last updated | Oct 6th, 2011 - about 13 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 | 1366741258 | NPPES |
| Other | 5704780 | NCPDP | |
| MEDICAID | 003511300 | NCPDP | |
| Other | 003511301 | NCPDP |
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