HOLIDAY CVS LLC (NPI# 1174627061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174627061 |
| Entity Type | Organization |
| Organization Name | HOLIDAY CVS LLC |
| Other Organization Name | CVS PHARMACY #03204 |
| Practice Address |
5010 S Florida Ave Lakeland FL 33813-2510 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8636442411 |
| Practice Fax Number | 8636484696 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-08-23 |
| 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 | 20556 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1034090 | 01 | |
| FL | 105574700 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #03204 | 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 |
5010 S FLORIDA AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-2510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381137 | Janae Thompkins | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2020-09-21 |
| 1528600376 | Lashunna L Mccall | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2019-10-14 |
| 1164961207 | Jean Michelle Garcia | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2017-02-22 |
| 1043562184 | Danielle Bennett Baldwin | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2012-10-14 |
| 1710260153 | Jennifer Lynn Ksaibati | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2011-09-22 |
| 1891076048 | Anne Stouten | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2011-09-01 |
| 1093945594 | Ludmyla J. Staddon | Nurse Practitioner | 5010 S Florida Ave, Lakeland, FL 33813-2510 | 2009-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| 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 |
|---|---|---|---|---|
| 1518577576 | Publix Super Markets, Inc | Pharmacy | 7340 Kathleen Rd, Lakeland, FL 33810-4495 | 2020-08-05 |
| 1891321089 | Eagle Pharmacy LLC | Pharmacy | 330 Eagles Landing Dr Ste 172, Lakeland, FL 33810-3041 | 2020-03-19 |
| 1659821437 | Arriva Medical, LLC | Pharmacy | 310 Eagles Landing Dr, Lakeland, FL 33810-2999 | 2016-10-05 |
| 1598214702 | Potter's Hand LLC | Pharmacy | 2180 E County Road 540a, Lakeland, FL 33813-3740 | 2016-09-28 |
| 1568891125 | Providence Pharmacy LLC | Pharmacy | 5515 Us Highway 98 N Ste 1, Lakeland, FL 33809-3133 | 2013-11-04 |
| 1487905840 | Eagle Pharmacy LLC | Pharmacy | 350 Eagles Landing Dr., Lakeland, FL 33810-2899 | 2012-09-26 |
| 1023374063 | Eagle Lake Pharmacy Inc | Pharmacy | 5245 A U S Hwy 98 N, Suite A, Lakeland, FL 33809 | 2012-04-04 |
| 1093974982 | Welldynerx LLC | Pharmacy | 500 Eagles Landing Dr, Lakeland, FL 33810-2899 | 2008-06-05 |
| 1306982913 | Sun and Lake Pharmacy Services, Inc | Pharmacy | 1231 Lakeland Hills Blvd, Lakeland, FL 33805-4673 | 2007-01-30 |
| 1679623987 | Careplus Pharmacy Corp | Pharmacy | 3020 S Combee Rd, Lakeland, FL 33803-7306 | 2007-01-11 |
| Find all providers in LAKELAND | ||||
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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.