Holiday CVS LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

HOLIDAY CVS LLC

Doing business as

CVS Pharmacy # 10644

Practice address

9701 SW 72ND St
Miami, FL 33173-4615

Phone

(305) 273-1247

NPI assigned

Mar 6, 2017

Last updated

May 4, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Colbert

Title

Sr. Director, Payer Relations

Phone

(401) 770-2751

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• CVS Pharmacy # 10644 Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc.

  dba CVS Pharmacy #17247

  • Pharmacy
  • North Dartmouth, MA
  • NPI 1831271071

  Member Of

  NPD member

Networks

• HealthSun Health Plans Network

Practitioners 4

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.

• Anabel De la Barrera

  • Pharmacist
  • Miami, FL
  • NPI 1982209359
  NPD (past)
• Michel Montes de Oca

  • Pharmacist
  • Miami, FL
  • NPI 1467057067
  NPD (past)
• Hassan Moussadda

  • Pharmacist
  • Miami, FL
  • NPI 1992429096
  NPD (past)
• Newton Walker, PHARMD

  • Pharmacist
  • Miami, FL
  • NPI 1104421171
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1942740238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500",
            "fax_number": "401-770-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331734615",
            "telephone_number": "305-273-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLIDAY CVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5734113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy # 10644",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holiday CVS LLC (Navarro Discount Pharmacy #10706)
• Holiday CVS LLC (CVS Pharmacy 03121)
• Holiday CVS LLC (CVS Pharmacy #00580)
• Holiday CVS LLC (Navarro Discount #10704)
• Holiday CVS LLC (Navarro Discount Pharmacy #10720)
• Holiday CVS LLC
• Holiday CVS, L.L.C (Navarro Discount Pharmacy # 11509)
• Holiday CVS, L.L.C. (CVS Pharmacy # 00402)
• Holiday CVS, L.L.C. (CVS Pharmacy #03401)
• Holiday CVS, L.L.C. (Cvs Pharmacy #17812)

• Pharmacy in Miami, FL
• Providers in Miami, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.

Verify at the official NPI Registry.