NPIMap

Holiday CVS LLC

Organization Active NPI Pharmacy · Wesley Chapel, FL

NPI 1104070101 · NPPES record last updated Mar 11, 2010

Key facts

NPI
1104070101
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
Legal business name
HOLIDAY CVS LLC
Practice address
30050 County Line Rd
Wesley Chapel, FL 33543
Phone
(813) 907-1423
NPI assigned
Nov 5, 2008
Organization subpart
No

Authorized official

Name
Susan F Colbert
Title
Director Pharmacy Enrollments
Phone
(401) 765-2751

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2227484Holiday CVS, LLC Dba CVS/Pharmacy #4362
30050 County Line Rd, Wesley Chapel, FL 33543		Certificate of waiverJun 13, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #04362
30050 County Line Rd, Wesley Chapel, FL 33543-6707 · (813) 907-1423		 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
Participating since Jan 1, 2025

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081223000620 FL Part B Supplier - Mass Immunization (Roster Biller Only) 2668534702 This NPI is an additional NPI on the enrollment
O20100930062318 FL DME Supplier - Pharmacy 2668534702 Practice locations: Wesley Chapel, FL

National Provider Directory

Tax ID family
Holiday CVS LLC (738 organizations share this tax ID)

Networks

  • Freedom Health HMO Network
    Plans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO Network
    Plans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

30050 County Line Rd
Wesley Chapel, FL 33543

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
1039343OtherNCPDP
000635900MedicaidFL
000635901OtherFLDME

Other names

  • CVS PHARMACY# 04362 Doing business as

Other providers in Wesley Chapel, FL

All providers in Wesley Chapel, FL · Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.