HOLIDAY CVS LLC (NPI# 1780820126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780820126 |
| Entity Type | Organization |
| Organization Name | HOLIDAY CVS LLC |
| Other Organization Name | CVS PHARMACY #17500 |
| Practice Address |
2950 S Blue Angel Pkwy Pensacola FL 32506-6905 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8504543001 |
| Practice Fax Number | 8504543011 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2009-01-06 |
| 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 29708 | FL | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2118403 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17500 | 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 |
2950 S BLUE ANGEL PKWY |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32506-6905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992127724 | Lance Ryan Staton | Pharmacist | 2950 S Blue Angel Pkwy, Pensacola, FL 32506-6905 | 2014-01-14 |
| 1245507813 | Beverly High Jackson | Pharmacist | 2950 S Blue Angel Pkwy, Pensacola, FL 32506-6905 | 2011-11-25 |
| 1356636294 | Doty Roye | Pharmacist | 2950 S Blue Angel Pkwy, T-2445, Pensacola, FL 32506-6905 | 2011-06-17 |
| 1982998233 | Matthew D Etheredge | Pharmacist | 2950 S Blue Angel Pkwy, T-2445, Pensacola, FL 32506-6905 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332942 | Abigail Irene Dudek | Behavior Technician | 6800 West Us-98, Pensacola, FL 32506 | 2020-06-26 |
| 1053957274 | Melissa Marie Swango | Technician | 3 Usher Cir, Pensacola, FL 32506 | 2019-11-22 |
| 1215479506 | Kerry Jo Pham | Advanced Practice Midwife | 225 N New Warrington Rd, Pensacola, FL 32506 | 2016-11-17 |
| 1750761375 | Congleton Eye Care, LLC | Optometrist | 4600 Mobile Hwy, Suite 122, Pensacola, FL 32506 | 2015-06-09 |
| 1033312293 | Rogelio Tridanio Martinez Sr. | Pain Medicine | 4806 Mobile Highway, Suite D, Pensacola, FL 32506 | 2007-06-06 |
| 1215023726 | Martha Goff | Pharmacist | 50 S. Blue Angel Parkway, Pensacola, FL 32506 | 2006-10-04 |
| 1881703635 | John Daniel Hodge | Dentist | 4800 W Fairfield Dr, Pensacola, FL 32506 | 2006-08-29 |
| 1417066275 | Fairfield Dental Center | Dentist | 4800 W. Fairfield Drive, Pensacola, FL 32506 | 2006-08-29 |
| 1942277793 | Phillip Martine Drlicka | Dentist | 901 N Warrington Rd, Pensocola, FL 32506 | 2006-03-01 |
| 1083694186 | Lester Shawn Bowling | Internal Medicine | 321 South Fairfield Dr, Pensacola, FL 32506 | 2006-01-17 |
| Find all providers in zip 32506 | ||||
| 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 |
|---|---|---|---|---|
| 1922415140 | Physician Specialty Pharmacy LLC | Pharmacy | 6258 N W St, Pensacola, FL 32505-1903 | 2014-07-21 |
| 1457417347 | Andersons Thrif-t Drugs Inc | Pharmacy | 4350 Bayou Blvd, Pensacola, FL 32503-1948 | 2006-12-28 |
| 1245342179 | Marando Inc | Pharmacy | 5507 N W St, Pensacola, FL 32505-2435 | 2006-08-31 |
| 1922113125 | Brunos Inc | Pharmacy | 3 W Nine Mile Rd, Pensacola, FL 32534-1279 | 2006-08-20 |
| 1841221959 | K Mart Corp | Pharmacy | 4211 Mobile Hwy, Pensacola, FL 32506-4205 | 2006-07-06 |
| 1750327219 | Rx Advantage Inc | Pharmacy | 2256 W Nine Mile Rd Ste B, Pensacola, FL 32534-9471 | 2006-06-22 |
| 1568409993 | Albertsons LLC | Pharmacy | 5055 N 9th Ave, Pensacola, FL 32504-8719 | 2006-06-02 |
| 1811934342 | Albertsons LLC | Pharmacy | 5998 Mobile Hwy, Pensacola, FL 32526-1873 | 2006-06-01 |
| 1760429435 | Albertsons LLC | Pharmacy | 2180 W Nine Mile Rd, Pensacola, FL 32534-9472 | 2006-06-01 |
| 1063459519 | Albertsons LLC | Pharmacy | 9251 University Pkwy, Pensacola, FL 32514-5531 | 2006-06-01 |
| Find all providers in PENSACOLA | ||||
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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.