Cvs Pharmacy 05189

LBN: Holiday Cvs Llc
Cvs Pharmacy 05189 is an health care organization with primary practice located at 1551 County Road 220 , Orange Park FL 32003-7926. 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) 215-1056, or through Colbert, Susan via phone (401) 770-2751.

Contact Information

Primary practice address
1551 County Road 220 Orange Park FL 32003-7926
Phone: (904) 215-1056
Fax: (904) 215-9307
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan
Phone: (401) 770-2751

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 20222 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1912001991
LBN Legal business name Holiday Cvs Llc
DBA Doing business as Cvs Pharmacy 05189
Authorized official Colbert, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Sep 27th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912001991 NPPES
Other 1002029 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 021688700 OTHER ID NUMBER-COMMERCIAL NUMBER

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