Active NPI
Holiday CVS LLC
Doing business as CVS Pharmacy #03755
- Pharmacy
- St Petersburg, FL
National Provider Identifier
1780788653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PH18612
- Legal business name
- HOLIDAY CVS LLC
- Doing business as
- CVS Pharmacy #03755
- Practice address
- 5405 49TH St N
St Petersburg, FL 33709-2101 - Phone
- (727) 527-8285
- NPI assigned
- Sep 12, 2006
- Last updated
- Nov 1, 2012
- 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
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | PH18612 | FL | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
5405 49TH St N
St Petersburg, FL 33709-2101
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1095858 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY #03755
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 |
| O20100930071604 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: Saint Petersburg, 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 |
|---|---|---|
| CVS Pharmacy #03755 | 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
- 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.
-
- Community/Retail Pharmacy
- Jacksonville, FL
- NPI 1801246251
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
5405 49th St N
St Petersburg, FL 33709
Phone (727) 527-8285
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Practitioners & affiliated clinicians
Practitioners 2
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
- St Petersburg, FL
- NPI 1477157543
-
- Pharmacist
- St Petersburg, FL
- NPI 1376147645
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": "1351728000000",
"number": "1780788653",
"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",
"telephone_number": "401-765-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 49TH ST N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337092101",
"telephone_number": "727-527-8285"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2012-11-01",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"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": "FL",
"license": "PH18612",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1095858",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY #03755",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in St Petersburg, FL
- Holiday CVS LLC (CVS Pharmacy #03466)
- Holiday CVS LLC (CVS Pharmacy 00574)
- Holiday CVS LLC (CVS Pharmacy 00149)
- Holiday CVS LLC (CVS Pharmacy 03654)
- Holiday CVS LLC (CVS Pharmacy #05234)
- Holistic Coaching Treatment Center
- Holistic Maternity, LLC (Holistic Maternity)
- Sabrina Holland, LCSW
- Shaneena Holland, LMT
- Alexandra Hollander
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.