Active NPI
Holiday CVS LLC
Doing business as CVS Pharmacy 03261
- Pharmacy
- Fort Lauderdale, FL
National Provider Identifier
1689778573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 20245
- Legal business name
- HOLIDAY CVS LLC
- Doing business as
- CVS Pharmacy 03261
- Practice address
- 2701 Stirling Rd
Ft Lauderdale, FL 33312-6505 - Phone
- (954) 981-9670
- Fax
- (954) 981-2449
- NPI assigned
- Sep 12, 2006
- Last updated
- Dec 4, 2009
- 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
- Cristiana Mauricio
- Title
- MGR Phcy Enrollments
- Phone
- (401) 770-2937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 20245 | FL | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
2701 Stirling Rd
Ft Lauderdale, FL 33312-6505
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other names 1
- CVS PHARMACY 03261
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 |
| O20100930098123 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: Fort Lauderdale, 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.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2227316 | Holiday CVS, LLC Dba CVS/Pharmacy #3261 | Certificate of waiver | Jun 9, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy # 03261 | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- Holiday CVS
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.
Networks
- Freedom Health HMO Network
- HealthSun Health Plans Network
- Optimum HealthCare HMO Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Fort Lauderdale, FL
- NPI 1598483497
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": "1259884800000",
"number": "1689778573",
"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": "2701 STIRLING RD",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333126505",
"telephone_number": "954-981-9670",
"fax_number": "954-981-2449"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2009-12-04",
"status": "A",
"authorized_official_last_name": "MAURICIO",
"authorized_official_first_name": "CRISTIANA",
"authorized_official_title_or_position": "MGR PHCY ENROLLMENTS",
"authorized_official_telephone_number": "401-770-2937"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "20245",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 03261",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Lauderdale, FL
- Holiday CVS LLC (CVS Pharmacy 00981)
- Holiday CVS LLC (CVS Pharmacy#03285)
- Holiday CVS LLC (CVS Pharmacy 04681)
- Holiday CVS LLC (CVS Pharmacy #00410)
- Holiday CVS LLC (CVS Pharmacy #16524)
- Holiday CVS LLC (CVS Pharmacy 03627)
- Holiday CVS LLC (CVS Pharmacy #04201)
- Holistic Lifecare Solutions, Inc.
- Holistic Massage & Wellness Clinics
- Holistic Nursing Staffing LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.