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HOLIDAY CVS LLC NPI 1043313794


NPI Information

NPI: 1043313794
Provider Name: HOLIDAY CVS LLC

Doing Business As: CVS PHARMACY # 04015

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
302 E JAMES LEE BLVD
CRESTVIEW, FL
ZIP 32539
Phone: (850) 682-1002
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HOLIDAY CVS LLC is a pharmacy in Crestview, FL. The provider is 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. HOLIDAY CVS LLC NPI is 1043313794. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy # 04015.

The provider's business location address is:

302 E JAMES LEE BLVD
CRESTVIEW, FL
ZIP 32539-827
Phone: (850) 682-1002

The provider's authorized official is Susan F Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-2751.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 11/1/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacyPH14346FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15140820669MEDICARE NSC
21052428OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3BC034CMEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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