NPIMap

Holiday CVS LLC

Organization Active NPI Pharmacy · Estero, FL

NPI 1104920180 · NPPES record last updated Sep 11, 2012

Key facts

NPI
1104920180
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
20764 (FL)
Legal business name
HOLIDAY CVS LLC
Practice address
11241 Miromar Square Blvd
Estero, FL 33928-6229
Phone
(239) 992-6168
Fax
(239) 992-8133
NPI assigned
Sep 12, 2006
Organization subpart
No

Authorized official

Name
Susan F Colbert
Title
Director, Payer Relations
Phone
(401) 770-2751

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.

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy # 03281
11241 Miromar Square Blvd, Estero, FL 33928-6229 · (239) 992-6168		 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
O20100930058634 FL DME Supplier - Pharmacy 2668534702 Practice locations: Estero, FL

National Provider Directory

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

Networks

  • 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)
  • 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)…

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 20764 FL Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

11241 Miromar Square Blvd
Estero, FL 33928-6229

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
026440700MedicaidFL
1001255OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names

  • CVS PHARMACY #03281 Doing business as

Other providers in Estero, FL

All providers in Estero, FL · Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.