NPIMap

Organization Active NPI

Holiday CVS LLC

Doing business as CVS Pharmacy 05180

  • Pharmacy
  • Pensacola, FL
National Provider Identifier
1033216528
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
20198 Issued in FL
Legal business name
HOLIDAY CVS LLC
Doing business as
CVS Pharmacy 05180
Practice address
4500 Saufley Field Rd
Pensacola, FL 32526
Phone
(850) 944-8966
Fax
(850) 941-0094
NPI assigned
Sep 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan F Colbert
Title
Director Phcy Enrollments
Phone
(401) 770-2751

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 20198 FL Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4500 Saufley Field Rd
Pensacola, FL 32526

Mailing address

1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
1082750OtherOTHER ID NUMBER-COMMERCIAL NUMBER
106359600MedicaidFL

Other names 1

  • CVS PHARMACY 05180 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081223000620 FL Part B Supplier - Mass Immunization (Roster Biller Only) 2668534702 This NPI is an additional NPI on the enrollment
O20100930055832 FL DME Supplier - Pharmacy 2668534702 Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory
Tax ID family
CVS738 organizations share this tax ID, including this one

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.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1033216528",
    "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",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAUFLEY FIELD RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32526",
            "telephone_number": "850-944-8966",
            "fax_number": "850-941-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLIDAY CVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR PHCY ENROLLMENTS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "20198",
            "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": "1082750",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106359600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY 05180",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.