Cvs Pharmacy 03198

LBN: Holiday Cvs Llc
Cvs Pharmacy 03198 is an health care organization with primary practice located at 175 State Road 312 W , St Augustine FL 32086-4201. 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 (904) 824-6167, or through Colbert, Susan F via phone (401) 770-2937.

Contact Information

Primary practice address
175 State Road 312 W St Augustine FL 32086-4201
Phone: (904) 824-6167
Fax: (904) 824-2015
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan F
Phone: (401) 770-2937

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 20646 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1801990791
LBN Legal business name Holiday Cvs Llc
DBA Doing business as Cvs Pharmacy 03198
Authorized official Colbert, Susan F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Sep 24th, 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 1801990791 NPPES
Florida MEDICAID 105572100
Florida Other 1032402

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