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
4684 HIGHWAY 90
MARIANNA, FL32446
Phone: 850-526-3784
Fax: 850-526-5802
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X

* Indicates primary specialty

NPI Profile & details for HOLIDAY CVS LLC

NPI Number 1538263421
Legal business name
LBN
HOLIDAY CVS LLC
Authorized official SUSAN COLBERT - (EXEC DIR, RX SERVICES)
Entity Organization
Organization subpart No
Enumeration date 09/12/2006
Last updated 01/11/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: 20717
  • FL Medicaid: 106002300
  • Other: P00754232 MEDICARE RR
  • Other: 1033581 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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