HOLIDAY CVS LLC (NPI# 1912929530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912929530 |
| Entity Type | Organization |
| Organization Name | HOLIDAY CVS LLC |
| Other Organization Name | CVS PHARMACY #16289 |
| Practice Address |
4155 W Lake Mary Blvd Lake Mary FL 32746-2410 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 4073309190 |
| Practice Fax Number | 4075473513 |
| 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 29681 | FL | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2011790 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16289 | 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 |
4155 W LAKE MARY BLVD |
| City | LAKE MARY |
| State | FL |
| Zip Code | 32746-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972978112 | Smita Shrivastava | Pharmacist | 4155 W Lake Mary Blvd, Lake Mary, FL 32746-2410 | 2015-12-13 |
| 1891194007 | Dao Thi Bich Tran | Pharmacist | 4155 W Lake Mary Blvd, Lake Mary, FL 32746-2410 | 2014-08-14 |
| 1316221203 | Diptesh Amin | Pharmacist | 4155 W Lake Mary Blvd, Lake Mary, FL 32746-2410 | 2011-10-10 |
| 1861789497 | Alexandra Cartaya Todd | Pharmacist | 4155 W Lake Mary Blvd, Target 0845, Lake Mary, FL 32746-2410 | 2011-07-04 |
| 1477625978 | Angela Denise Adams | Pharmacist | 4155 W Lake Mary Blvd, Lake Mary, FL 32746-2410 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286397 | James Maggert | Physical Therapist | Sst Rehab, 635 Century Pt - Suite 111, Lake Mary, FL 32746 | 2020-05-14 |
| 1225663743 | Jamie Pecot | Behavior Technician | 300 International Parkway, 200, Lake Mary, FL 32746 | 2020-03-04 |
| 1619509585 | Dental Associates of Heathrow, LLC | Dentist | Dental Associates of Heathrow, LLC, 120 International Parkway Suite 26, Heathrow, FL 32746 | 2020-02-10 |
| 1376185876 | Rinehart Road Surgery Center, LLC | Clinic/Center | 392 Rinehart Road, Suite 1100, Lake Mary, FL 32746 | 2019-10-16 |
| 1871140988 | Central Florida Wellness LLC | General Practice | 1061 S Sun Drove, Suite 1041, Lake. Mary, FL 32746 | 2019-08-22 |
| 1326609942 | Antoine Slade I | Behavior Technician | 4876 Rhinehart Road, Lake Mary, FL 32746 | 2019-06-25 |
| 1245891209 | Ohri, LLC | Clinic/Center | 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 | 2019-06-21 |
| 1336610856 | Olivia Laurel Stolz | Physician Assistant | 3300 West Lake Mary Blvd, 220, Lake Mary, FL 32746 | 2018-12-10 |
| 1881171072 | Elite-star Medical Transport LLC. | Non-emergency Medical Transport (VAN) | 2910 W Lake Mary Blvd Ste 101, Lake Mary, FL 32746 | 2018-07-20 |
| 1508351537 | Ariagny Elena Fereira | Speech-Language Pathologist | 145 Middle Street Suite 1101, Lake Mary, FL 32746 | 2018-06-22 |
| Find all providers in zip 32746 | ||||
| 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] |
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|---|---|---|---|---|
| 1992736029 | K Mart Corp | Pharmacy | 3639 Lake Emma Rd, Lake Mary, FL 32746-6198 | 2006-07-06 |
| 1285671701 | Albertsons LLC | Pharmacy | 870 Village Oak Ln, Lake Mary, FL 32746-4766 | 2006-06-01 |
| 1104827724 | Priority Healthcare Pharmacy Inc. | Pharmacy | 250 Technology Park, Lake Mary, FL 32746-7115 | 2005-08-04 |
| 1992052013 | Avella of Orlando, Inc. | Pharmacy | 100 Technology Park, Suite 155, Lake Mary, FL 32746-6297 | 2012-08-08 |
| 1164746608 | Solantic of Orlando, LLC | Pharmacy | 136 Parliament Loop, Suite 102, Lake Mary, FL 32746-3592 | 2010-03-25 |
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| 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.