Active NPI
Holiday CVS LLC
Doing business as CVS Pharmacy# 02379
- Pharmacy
- Miami, FL
National Provider Identifier
1003213125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- HOLIDAY CVS LLC
- Doing business as
- CVS Pharmacy# 02379
- Practice address
- 12180 SW 8TH St
Miami, FL 33184-1635 - Phone
- (305) 554-4464
- NPI assigned
- Dec 4, 2014
- Last updated
- Jun 30, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Sr Director,Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
12180 SW 8TH St
Miami, FL 33184-1635
Mailing address
1 CVS Dr
Box 1075 Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5724427 | Other | NCPDP | |
| 014816000 | Medicaid | FL |
Other names 1
- CVS PHARMACY# 02379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081223000620 | FL | Part B Supplier - Mass Immunization (Roster Biller Only) | 2668534702 | This NPI is an additional NPI on the enrollment |
| O20150618000428 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: Miami, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #02379 | Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Ent… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Holiday CVS LLC
Organizations with this tax ID in the same state 12
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
12180 SW 8th St
Miami, FL 33184
Phone (305) 554-4464
Networks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Miami, FL
- NPI 1346964673
-
- Pharmacist
- Miami, FL
- NPI 1376146068
-
- Pharmacist
- Miami, FL
- NPI 1629957998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417651200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1435622400000",
"number": "1003213125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075 PHARMACY ENROLLMENTS",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "401-765-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12180 SW 8TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331841635",
"telephone_number": "305-554-4464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-12-04",
"last_updated": "2015-06-30",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "SR DIRECTOR,PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5724427",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014816000",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY# 02379",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Miami, FL
- Gina Margarita Holan, OTR
- Hold the Lines
- Savannah L Holden, PA
- Cheryl Gertrude Holder, RN
- Iliana Holguin, OT
- Holiday CVS LLC (CVS Pharmacy 03655)
- Holiday CVS LLC (CVS Pharmacy #05197)
- Holiday CVS LLC (Navarro Discount Pharmacy #10705)
- Holiday CVS LLC (CVS Pharmacy #05154)
- Holiday CVS LLC (CVS Pharmacy #17665)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.