Active NPI
Holiday CVS LLC
Doing business as Navarro Discount Pharmacy #10709
- Pharmacy
- Miami Beach, FL
National Provider Identifier
1619082732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- HOLIDAY CVS LLC
- Doing business as
- Navarro Discount Pharmacy #10709
- Practice address
- 631 76 Street
Miami Beach, FL 33141 - Phone
- (305) 636-7779
- NPI assigned
- Aug 20, 2006
- Last updated
- Jun 3, 2015
- 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 Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
631 76 Street
Miami Beach, FL 33141
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 012823900 | Medicaid | FL | |
| 1094197 | Other | FL | NCPDP |
| 012823901 | Other | FL | MEDICAID DME |
Other names 1
- NAVARRO DISCOUNT PHARMACY #10709
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 |
| O20141223001042 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: Miami Beach, FL |
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
631 71st St
Miami Beach, FL 33141
Phone (305) 865-0075
Networks
- HealthSun Health Plans Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1433289600000",
"number": "1619082732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"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": "631 76 STREET",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "33141",
"telephone_number": "305-636-7779"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-20",
"last_updated": "2015-06-03",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "012823900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1094197",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "012823901",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "NAVARRO DISCOUNT PHARMACY #10709",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.