Active NPI
Holiday CVS LLC
Doing business as CVS Pharmacy
- Pharmacy
- North Miami Beach, FL
National Provider Identifier
1023112901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 20732
- Legal business name
- HOLIDAY CVS LLC
- Doing business as
- CVS Pharmacy
- Practice address
- 1825 NE Miami Gardens Dr
North Miami Beach, FL 33179-5035 - Phone
- (305) 932-5740
- Fax
- (305) 933-8968
- NPI assigned
- Sep 12, 2006
- Last updated
- Jul 11, 2012
- 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
- Director Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 20732 | FL | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1825 NE Miami Gardens Dr
North Miami Beach, FL 33179-5035
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1005671 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 105913100 | Medicaid | FL |
Other names 1
- CVS PHARMACY
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 |
| O20100930055569 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: North Miami Beach, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Holiday CVS LLC
Organizations with this tax ID in the same state 24
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
1825 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 932-5740
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 1932705795
-
- Pharmacist
- North Miami Beach, FL
- NPI 1407617624
-
- Pharmacist
- North Miami Beach, FL
- NPI 1710582770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1341964800000",
"number": "1023112901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "PO BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 NE MIAMI GARDENS DR",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331795035",
"telephone_number": "305-932-5740",
"fax_number": "305-933-8968"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2012-07-11",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "20732",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1005671",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105913100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in North Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.