Cvs Pharmacy 04422

LBN: Holiday Cvs Llc
Cvs Pharmacy 04422 is an health care organization with primary practice located at 201 S State Road 19 , Palatka FL 32177-3937. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Holiday Cvs Llc can be contacted via phone (386) 325-7576, or through Colbert, Susan F via phone (401) 770-2751.

Contact Information

Primary practice address
201 S State Road 19 Palatka FL 32177-3937
Phone: (386) 325-7576
Fax: (904) 325-8195
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan F
Phone: (401) 770-2751

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 20567 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1477657328
LBN Legal business name Holiday Cvs Llc
DBA Doing business as Cvs Pharmacy 04422
Authorized official Colbert, Susan F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Nov 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477657328 NPPES
Other 1064865 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 105555100 OTHER ID NUMBER-COMMERCIAL NUMBER

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