Cvs Pharmacy #04361
LBN: Holiday Cvs Llc
Cvs Pharmacy #04361 is an health care organization with primary practice located at 1920 A1A S , Saint Augustine FL 32080-6508. 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 (904) 471-2010, or through Colbert, Susan F via phone (401) 770-2751.
Contact Information
Primary practice address
1920 A1A S
Saint Augustine FL 32080-6508
Phone: (904) 471-2010
Fax: (904) 461-8607
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 20566 | Florida |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1659475507 |
|---|---|
| LBN Legal business name | Holiday Cvs Llc |
| DBA Doing business as | Cvs Pharmacy #04361 |
| Authorized official | Colbert, Susan F |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Sep 26th, 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 | 1659475507 | NPPES |
| Other | 1064841 | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| MEDICAID | 105553400 | OTHER ID NUMBER-COMMERCIAL NUMBER |
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