Cvs Pharmacy 05171

LBN: Holiday Cvs Llc
Cvs Pharmacy 05171 is an health care organization with primary practice located at 1005 Ohio Ave S , Live Oak FL 32064-4129. 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 (386) 362-5183, or through Colbert, Susan F via phone (401) 770-2751.

Contact Information

Primary practice address
1005 Ohio Ave S Live Oak FL 32064-4129
Fax: (386) 362-4887
Website:
Authorized official contact:
Name: Colbert, Susan F

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X Florida
Suppliers / Pharmacy 333600000X 20700 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1205930161
LBN Legal business name Holiday Cvs Llc
DBA Doing business as Cvs Pharmacy 05171
Authorized official Colbert, Susan F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Nov 21st, 2012 - about 14 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 1205930161 NPPES
Other 1079169 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 105942400 OTHER ID NUMBER-COMMERCIAL NUMBER

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