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Contact Information

HOLIDAY CVS LLC
57 TUSCAN WAY
SAINT AUGUSTINE, FL32092
 Phone: 904-940-3817
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for HOLIDAY CVS LLC

NPI # 1295912079
LBN Legal business name HOLIDAY CVS LLC
Authorized official SUSAN COLBERT - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/24/2008
Last updated 09/23/2011 - About 15 years ago
Identifiers
FL Medicaid 032595300
FL Other 032595301 FL DME
FL Other 1032349 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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