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HOLIDAY CVS LLC NPI 1306943899


NPI Information

NPI: 1306943899
Provider Name: HOLIDAY CVS LLC

Doing Business As: CVS PHARMACY #04254

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 10D2223929

Address:
301 NE PRIMA VISTA BLVD
PORT SAINT LUCIE, FL
ZIP 34983
Phone: (772) 340-3640
Get Directions

HOLIDAY CVS LLC is a pharmacy in Port Saint Lucie, FL. The provider is 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. HOLIDAY CVS LLC NPI is 1306943899. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #04254.

The provider's business location address is:

301 NE PRIMA VISTA BLVD
PORT SAINT LUCIE, FL
ZIP 34983
Phone: (772) 340-3640
Fax: (772) 871-6186

The provider's authorized official is Susan Colbert .
The authorized official title is Director Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 10D2223929 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2006 and was last updated on 11/15/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2333600000XPharmacy20692FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11073826OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2105546100MEDICAIDFLORIDA
3BC034AMEDICARE PIN
4P00949648MEDICARE PIN
55140820439MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.