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
1141 HIGHWAY 20
INTERLACHEN, FL32148
Phone: 386-684-4991
Fax: 386-684-3029
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for HOLIDAY CVS LLC

NPI Number 1609971431
Legal business name
LBN
HOLIDAY CVS LLC
Authorized official SUSAN COLBERT - (EXEC DIR, RX SERVICES)
Entity Organization
Organization subpart No
Enumeration date 09/14/2006
Last updated 01/12/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: 20432
  • FL Medicaid: 105607700
  • Other: 1054713 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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