National Provider Identifier Database

HOLIDAY CVS LLC
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

HOLIDAY CVS LLC
1300 SW ST LUCIE BLVD
PORT SAINT LUCIE, FL34986
Phone: 772-878-7078
Fax: 772-343-0608
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for HOLIDAY CVS LLC

NPI Number 1124125612
Legal business name
LBN
HOLIDAY CVS LLC
Authorized official SUSAN COLBERT - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 09/19/2006
Last updated 01/17/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: 20592
  • FL Medicaid: 106175500
  • Other: 1080439 OTHER ID NUMBER-COMMERCIAL NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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