HOLIDAY CVS LLC (NPI# 1285738195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285738195 |
| Entity Type | Organization |
| Organization Name | HOLIDAY CVS LLC |
| Other Organization Name | CVS PHARMACY #03639 |
| Practice Address |
420 N Main St Bushnell FL 33513-5427 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 3527938577 |
| Practice Fax Number | 3527935374 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-11-14 |
| Authorized Official Name | SUSAN F COLBERT (DIRECTOR PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 20460 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 105590900 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1049623 | 01 | |
| MEDICARE RR | P00754232 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #03639 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238321 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 15996 Preserve Marketplace Blvd, Odessa, FL 33556-5513 | 2020-09-04 |
| 1548885460 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 11619 Daryl Carter Parkway, Orlando, FL 32821 | 2020-06-16 |
| 1811517758 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 1120 E Kennedy Blvd Unit 126, Tampa, FL 33602-3581 | 2020-04-21 |
| 1346880481 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 1906 Ponce De Leon Boulvard, Coral Gables, FL 33134 | 2020-01-07 |
| 1326697335 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 400 Clematis St, West Palm Beach, FL 33401-5321 | 2019-09-11 |
| 1861049090 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 11521 Sr 70 East, Bradenton, FL 34202 | 2019-08-22 |
| 1144874793 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 802 E 25th St, Hialeah, FL 33013-3402 | 2019-07-31 |
| 1134605025 | Holiday Cvs LLC | Pharmacy | 13400 Immokalee Rd, Naples, FL 34120 | 2018-07-14 |
| 1669986766 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 2962 Aventura Blvd, Aventura, FL 33180-3103 | 2017-11-28 |
| 1942740238 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 9701 Sw 72nd St, Miami, FL 33173-4615 | 2017-03-06 |
| Street Address |
420 N MAIN ST |
| City | BUSHNELL |
| State | FL |
| Zip Code | 33513-5427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619465481 | Crystal Wallace Goddin | Physical Therapy Assistant | 1104 N Main St, Bushnell, Fl, Bushnell, FL 33513 | 2018-04-27 |
| 1255836920 | Anton Dawson | Behavior Technician | 2310 Cr 615, Bushnell, FL 33513 | 2018-03-26 |
| 1942728431 | Carolyn Sue Guarino | Licensed Practical Nurse | 10306 S.w. 53rd Terr., Bushnell, FL 33513 | 2017-09-05 |
| 1326321258 | Edith Marie Evans | Case Manager/Care Coordinator | 2891 C.r. 615b, Bushnell, FL 33513 | 2011-09-27 |
| 1144478439 | Emma J Ridley | Pharmacist | Sumter Oaks Park, 4602 Couny Rd. 673, #14107, Bushnell, FL 33513 | 2008-08-29 |
| 1205083268 | Diana K Mullin | Day Training, Developmentally Disabled Services | 9325 Cr 622 G, Bushnell, FL 33513 | 2008-08-21 |
| 1467625202 | Amy's Caring Hands | Day Training, Developmentally Disabled Services | 1612 W County Road 476, Bushnell, FL 33513 | 2008-04-11 |
| 1821212952 | Stuart J Kaufman Md & Assoc Pa | Ophthalmology | 1814 West Cr 48, Bushnell, FL 33513 | 2007-04-12 |
| 1740201128 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1122 N Main St, Bushnell, FL 33513 | 2006-07-21 |
| 1184688947 | Florida Department of Health | Public Health or Welfare | 415 E Noble Ave, Bushnell, FL 33513 | 2006-04-17 |
| Find all providers in zip 33513 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023341716 | Bushnell Pharmacy LLC | Pharmacy | 417 N West St, Bushnell, FL 33513-6021 | 2009-09-11 |
| 1083848865 | Annalice LLC | Pharmacy | 115 W Belt Ave, Bushnell, FL 33513-5101 | 2009-05-08 |
| 1285787226 | Axline Pharmacy Inc | Pharmacy | 401 W Main St, Bushnell, IL 61422-1353 | 2007-01-22 |
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|---|---|---|---|---|
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| 1225641525 | Englewood Pharmaceutical Services Inc | Pharmacy | 1720 S Mccall Rd Ste J, Englewood, FL 34223-4867 | 2020-08-26 |
| 1972115103 | Intellrx Consulting LLC | Pharmacy | 1257 The 12th Fairway, Wellington, FL 33414-5738 | 2020-08-19 |
| 1518577576 | Publix Super Markets, Inc | Pharmacy | 7340 Kathleen Rd, Lakeland, FL 33810-4495 | 2020-08-05 |
| 1962011890 | Green Star Pharmacy | Pharmacy | 2950 Winkler Ave Ste 701, Fort Myers, FL 33916-9322 | 2020-07-27 |
| 1356959134 | Cverx Pharmacy Corp | Pharmacy | 7360 Sw 24th St Ste 29, Miami, FL 33155-1462 | 2020-07-17 |
| 1447877287 | Jerry Voltaire | Pharmacy | 16470 Cedar Run Dr, Orlando, FL 32828-6970 | 2020-06-27 |
| 1598381980 | John Melvin Schemm IIi | Pharmacy | 7617 Bay Port Rd, Orlando, FL 32819-5504 | 2020-06-22 |
| 1891318267 | Empire Specialty Pharmacy LLC | Pharmacy | 749 S Apollo Blvd, Melbourne, FL 32901-1457 | 2020-05-20 |
| 1992334205 | Mypills Pharmacy LLC | Pharmacy | 303a E 1st St, Sanford, FL 32771-1377 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.