Active NPI
Holiday CVS LLC
Doing business as CVS Pharmacy #03746
- Pharmacy
- Spring Hill, FL
National Provider Identifier
1619071685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 20352
- Legal business name
- HOLIDAY CVS LLC
- Doing business as
- CVS Pharmacy #03746
- Practice address
- 11115 Spring Hill Dr
Spring Hill, FL 34609-4649 - Phone
- (352) 686-1336
- Fax
- (352) 666-6925
- NPI assigned
- Sep 12, 2006
- Last updated
- Jan 12, 2023
- 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 F Colbert
- Title
- Exec Dir, RX Services
- Phone
- (401) 770-2751
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 20352 | FL | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
11115 Spring Hill Dr
Spring Hill, FL 34609-4649
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106128300 | Medicaid | FL | |
| 1054989 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| P00754232 | Other | MEDICARE RR |
Other names 1
- CVS PHARMACY #03746
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
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 |
| O20100930055173 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: Spring Hill, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Holiday CVS LLC | Immunosuppressive Drugs|Infusion 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|Urologic… | Does not accept assignment |
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
11115 Spring Hill Dr
Spring Hill, FL 34609
Phone (352) 346-0680
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
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": "1673481600000",
"number": "1619071685",
"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": "11115 SPRING HILL DR",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346094649",
"telephone_number": "352-686-1336",
"fax_number": "352-666-6925"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2023-01-12",
"certification_date": "2023-01-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "EXEC DIR, RX SERVICES",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "20352",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106128300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1054989",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00754232",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "CVS PHARMACY #03746",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CVS PHARMACY #03746",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Spring Hill, FL
- Terra C Hodges
- Stacey Hoffman, APRN, FNP-C
- Natalie Hofmeister, MS, RDN, LD/N
- Holiday CVS LLC (CVS Pharmacy #08380)
- Holiday CVS LLC (CVS Pharmacy #16343)
- Heather S Holop, LCSW
- Michelle Jeanette Holt, APRN
- Home Health Specialists, LLC (Concierge Home Care)
- Hoof to Heart Healing LLC
- Yonnette Rhonda Hooper
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.