HOLIDAY CVS LLC (NPI# 1164526133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164526133 |
| Entity Type | Organization |
| Organization Name | HOLIDAY CVS LLC |
| Other Organization Name | CVS PHARMACY #03814 |
| Practice Address |
4120 Henderson Blvd Tampa FL 33629-5750 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8132815353 |
| Practice Fax Number | 8132815356 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-03-19 |
| Authorized Official Name | SUSAN 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 | 20230 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1055284 | 01 | |
| FL | 105814200 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #03814 | 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 |
4120 HENDERSON BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33629-5750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285249763 | Krystin Marie Love | Nurse Practitioner | 4120 Henderson Blvd, Tampa, FL 33629-5750 | 2020-09-11 |
| 1629590260 | Brad Richert | Pharmacist | 4120 Henderson Blvd, Tampa, FL 33629-5750 | 2017-07-14 |
| 1841658622 | Patrick Jonas Johnson | Nurse Practitioner | 4120 Henderson Blvd, Tampa, FL 33629-5750 | 2016-02-08 |
| 1407108475 | Ann Elizabeth Ross | Nurse Practitioner | 4120 Henderson Blvd, Tampa, FL 33629-5750 | 2012-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162612 | Jake Morris | Counselor | 4003 W Morrison Ave, Tampa, FL 33629 | 2018-04-25 |
| 1689192411 | Madalyn Turner | Chiropractor | 3409 W Bay To Bay Blvd Ste B, Tampa, FL 33629 | 2017-08-31 |
| 1063865673 | South Tampa Dental Studio | Dentist | 4306 West Kensington Ave., Tampa, FL 33629 | 2016-07-19 |
| 1093198160 | Mi Ae Kwon | Dentist | 3739 W. Neptune St., Tampa, FL 33629 | 2015-07-07 |
| 1013394568 | Etairos Health, Inc | In Home Supportive Care | 2301 W Palm Ave, Tampa, FL 33629 | 2015-05-05 |
| 1053702589 | Kantilal N. Bhadja, Md | Internal Medicine | 4223 W. El Prado Blvd, Tampa, FL 33629 | 2015-02-05 |
| 1801174016 | Wang & Cortes Dental | Dentist | 1008 South Clearview Avenue, Tampa, FL 33629 | 2011-07-22 |
| 1174826176 | Jada Rae Danielle Traub | Behavioral Analyst | 3271 S. Macdill Ave, Tampa, FL 33629 | 2010-12-13 |
| 1275849846 | Kara Dawson | Physical Therapy Assistant | 3614 South Dale Mabry, Tampa, FL 33629 | 2010-08-20 |
| 1225350580 | Monteleone & Kessler, P.l. | Dentist | 4014 W. Estrella St., Suite B, Tampa, FL 33629 | 2010-02-26 |
| Find all providers in zip 33629 | ||||
| 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 |
|---|---|---|---|---|
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1053804591 | Nagaindra Srivastav | Pharmacy | 17931 Cachet Isle Dr, Tampa, FL 33647-2703 | 2018-06-09 |
| 1902393556 | Perla C Beltran | Pharmacy | 3632 S Renellie Dr, Tampa, FL 33629-8350 | 2018-04-19 |
| 1215437694 | Tita Healthcare Inc. | Pharmacy | 12811 N Nebraska Ave Ste J, Tampa, FL 33612-4401 | 2018-02-13 |
| 1548789605 | Positiverx | Pharmacy | 1420 W Waters Ave # 1, Tampa, FL 33604-2830 | 2017-09-11 |
| 1346766482 | Genoa Healthcare, LLC | Pharmacy | 12512 Bruce B Downs Blvd Ste A142, Tampa, FL 33612-9209 | 2017-08-21 |
| 1093237000 | Shri Aarna Rx LLC | Pharmacy | 3134 E Hillsborough Ave, Tampa, FL 33610-4528 | 2017-07-11 |
| 1730618554 | Rightback LLC | Pharmacy | 6802 W Hillsborough Ave Ste 12, Tampa, FL 33634-5004 | 2017-06-06 |
| 1558817783 | Plamyra Pharmacy LLC | Pharmacy | 4817 E Busch Blvd, Tampa, FL 33617 | 2016-08-28 |
| 1336694926 | U & J Healthcare LLC | Pharmacy | 6308 N Florida Ave, Tampa, FL 33604-6628 | 2016-08-24 |
| Find all providers in TAMPA | ||||
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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.