Cvs Pharmacy 03631

LBN: Holiday Cvs Llc
Cvs Pharmacy 03631 is an health care organization with primary practice located at 152 Front St , Ponte Vedra FL 32082-3058. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Holiday Cvs Llc can be contacted via phone (904) 285-3634, or through Colbert, Susan F via phone (401) 770-2751.

Contact Information

Primary practice address
152 Front St Ponte Vedra FL 32082-3058
Phone: (904) 285-3634
Fax: (904) 285-7378
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan F
Phone: (401) 770-2751

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 20314 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1003910910
LBN Legal business name Holiday Cvs Llc
DBA Doing business as Cvs Pharmacy 03631
Authorized official Colbert, Susan F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Dec 17th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003910910 NPPES
Other 1048481 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 105583600 OTHER ID NUMBER-COMMERCIAL NUMBER

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