HOLIDAY CVS LLC (NPI# 1780606384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780606384 |
| Entity Type | Organization |
| Organization Name | HOLIDAY CVS LLC |
| Other Organization Name | CVS PHARMACY #17090 |
| Practice Address |
4567 River City Dr Jacksonville FL 32246-7411 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 9045960021 |
| Practice Fax Number | 9044387567 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-09-22 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH 29641 | FL | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2004231 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17090 | 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 |
4567 RIVER CITY DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32246-7411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023417094 | David Ashley White | Pharmacist | 4567 River City Dr, Jacksonville, FL 32246-7411 | 2014-08-15 |
| 1578859468 | Michael Filipkowski Sr. | Pharmacist | 4567 River City Dr, Jacksonville, FL 32246-7411 | 2011-06-20 |
| 1558655845 | Shannon Beth Wygonik | Pharmacist | 4567 River City Dr, T-1974, Jacksonville, FL 32246-7411 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275179863 | Samar A Ibrahim | Pharmacist | 1305 N Orange Ave Green Cove Springs, Jacksonville, FL 32246 | 2019-11-19 |
| 1386290898 | Kelsey R Clevenger | Chiropractor | 4413 Town Center Parkway, Ste. 205, Jacksonville, FL 32246 | 2019-08-12 |
| 1700449006 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4712 Lake Center Drive, Space 107, Jacksonville, FL 32246 | 2019-04-22 |
| 1205399946 | Usa United Surgical Assistants | Clinic/Center | Bahri Surgical Center, 9726 Touchton Rd, Jacksonville, FL 32246 | 2019-04-10 |
| 1780173526 | Jules Novall LLC | Taxi | 4600 Touchton Rd, Jacksonville, FL 32246 | 2018-05-08 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1952770463 | Alignment Healthcare Florida LLC | Clinic/Center | 3520-1 St. Johns Bluff Rd., Jacksonville, FL 32246 | 2015-09-15 |
| 1558739417 | Jessica Brake | Physical Therapist | 9726 Touchton Road, Suite 104, Jacksonville, FL 32246 | 2015-09-09 |
| 1043686256 | Healthyeye Dba Vision Express LLC | Optometrist | 4871 Town Center Parkway #5, Jacksonville, FL 32246 | 2015-08-12 |
| 1477954675 | Joanivette Rodriguez | Psychologist | 3451 Saland Way Apt 504, Jacksonville, FL 32246 | 2014-09-08 |
| Find all providers in zip 32246 | ||||
| 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 |
|---|---|---|---|---|
| 1467954438 | De2 LLC | Pharmacy | 2624 Atlantic Blvd Ste 3, Jacksonville, FL 32207-3633 | 2018-03-06 |
| 1174037063 | Banyanites - 2 LLC | Pharmacy | 11048 Baymeadows Rd Unit 5, Jacksonville, FL 32256-9583 | 2017-11-30 |
| 1538600424 | Can Community Health Inc. | Pharmacy | 4615 Philips Hwy, Suite 3, Jacksonville, FL 32207-9506 | 2017-03-13 |
| 1871039701 | An&u Inc | Pharmacy | 1729 S Jackson St, Jacksonville, TX 75766-5832 | 2017-01-17 |
| 1114479821 | Trucare Ltc, LLC | Pharmacy | 2671 Huffman Blvd, Jacksonville, FL 32246-4056 | 2016-10-28 |
| 1083161038 | Cornerstone Pharmacy Jacksonville LLC | Pharmacy | 315 S James St, Jacksonville, AR 72076-4315 | 2016-09-07 |
| 1326591066 | Sprx2 Inc | Pharmacy | 1201 Monument Rd Ste 100, Jacksonville, FL 32225-6445 | 2016-07-29 |
| 1568822377 | Sprx Inc | Pharmacy | 3740 Saint Johns Bluff Rd S Ste 21, Jacksonville, FL 32224-2650 | 2016-03-07 |
| 1548648363 | Caremax Pharmacy 725 LLC | Pharmacy | 5547 Normandy Blvd, Jacksonville, FL 32205-6246 | 2015-05-13 |
| 1538563580 | Florida A and M University College of Pharmacy | Pharmacy | 2050 Art Museum Dr, Suite 200, Jacksonville, FL 32207-2595 | 2014-10-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32246 |
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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.