Cvs Pharmacy #05194

LBN: Holiday Cvs Llc
Cvs Pharmacy #05194 is an health care organization with primary practice located at 1081 Beal Pkwy Nw , Fort Walton Beach FL 32547-1439. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Holiday Cvs Llc can be contacted via phone (850) 863-4400, or through Vanderbrug, Patricia via phone (401) 770-1624.

Contact Information

Primary practice address
1081 Beal Pkwy Nw Fort Walton Beach FL 32547-1439
Phone: (850) 863-4400
Fax: (850) 863-4445
Website:
Map and Directions
Authorized official contact:
Name: Vanderbrug, Patricia
Phone: (401) 770-1624

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 20534 Florida
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1710081682
LBN Legal business name Holiday Cvs Llc
DBA Doing business as Cvs Pharmacy #05194
Authorized official Vanderbrug, Patricia
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2006
Last updated Dec 4th, 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 1710081682 NPPES
Other 1086695 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 021527900 OTHER ID NUMBER-COMMERCIAL NUMBER

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