Active NPI
Holiday CVS LLC
- Pharmacy
- Pensacola, FL
National Provider Identifier
1952408445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 20745
- Legal business name
- HOLIDAY CVS LLC
- Practice address
- 8100 N Davis Hwy
Pensacola, FL 32514-6093 - Phone
- (850) 477-2466
- Fax
- (850) 477-7135
- NPI assigned
- Sep 19, 2006
- 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 Phcy Enrollments
- Phone
- (401) 770-2751
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 20745 | FL | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
8100 N Davis Hwy
Pensacola, FL 32514-6093
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105560700 | Medicaid | FL | |
| 1064916 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY 04458
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 |
| O20100930030673 | FL | DME Supplier - Pharmacy | 2668534702 | Practice locations: Pensacola, 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 # 04458 | 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 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.
-
- Pharmacy
- Bradenton, FL
- NPI 1972419067
-
- Pharmacy
- Naples, FL
- NPI 1942417084
-
- Pharmacy
- Miami, FL
- NPI 1942480934
-
- Pharmacy
- Miami, FL
- NPI 1942797915
-
- Pharmacy
- Palm Harbor, FL
- NPI 1952323578
-
- Pharmacy
- Century, FL
- NPI 1952404600
-
- Pharmacy
- Sun City Center, FL
- NPI 1952405813
-
- Pharmacy
- Bradenton, FL
- NPI 1952405839
-
- Pharmacy
- Palm Coast, FL
- NPI 1952405847
-
- Pharmacy
- Fort Myers, FL
- NPI 1952405854
-
- Pharmacy
- Cocoa Beach, FL
- NPI 1952405938
-
- Pharmacy
- Trinity, FL
- NPI 1962424564
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
8100 N Davis Hwy
Pensacola, FL 32514
Phone (850) 454-9934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304640000000",
"number": "1952408445",
"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": "8100 N DAVIS HWY",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325146093",
"telephone_number": "850-477-2466",
"fax_number": "850-477-7135"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-19",
"last_updated": "2011-05-06",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "DIRECTOR PHCY ENROLLMENTS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "20745",
"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": "105560700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1064916",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY 04458",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.