HOLIDAY CVS LLC; NPI #1861595514

Contact Information

HOLIDAY CVS LLC

407 EAST BASE ST
MADISON, FL 32340

Phone: 850-973-3027
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

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NPI Profile & details for HOLIDAY CVS LLC

NPI Number 1861595514

LBN Legal business name HOLIDAY CVS LLC

Authorized official SUSAN COLBERT - (DIRECTOR, PAYER RELATIONS)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/07/2006

Last updated 11/01/2012 - About 14 years ago

Identifiers

FL	License #	PH14355
	Other	1062099	OTHER ID NUMBER-COMMERCIAL NUMBER

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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