Organization Name: | HOLIDAY CVS LLC |
NPI Number: | 1225132129 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN COLBERT (PHCY ENROLLMENTS REP) |
Mailing Address: | 1255 Ne Jensen Beach Blvd Jensen Beach |
State: | FL US |
Postal Code: | 349577221 |
Phone Number: | 7723344204 |
Fax Number: | 7723346743 |
NPI Enumeration Date: | 09/12/2006 |
NPI Last Update Date: | 11/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |