NPIMap

Holiday CVS LLC

Organization Active NPI Pharmacy · Tampa, FL

NPI 1598869463 · NPPES record last updated Aug 16, 2012

Key facts

NPI
1598869463
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
PH18633 (FL)
Legal business name
HOLIDAY CVS LLC
Practice address
3102 W Gandy Blvd
Tampa, FL 33611-2928
Phone
(813) 902-1833
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.

Practitioners 5

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

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
O20100930085516 FL DME Supplier - Pharmacy 2668534702 Practice locations: Tampa, 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 PH18633 FL Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

3102 W Gandy Blvd
Tampa, FL 33611-2928

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
1096002OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names

  • CVS PHARMACY 02802 Doing business as

Other providers in Tampa, FL

All providers in Tampa, FL · Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.