HOLIDAY CVS LLC NPI 1912001868

NPI Information

  • NPI: 1912001868
  • Provider Name: HOLIDAY CVS LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CVS PHARMACY #04465
  • CLIA Number: 10D2259259
  • Address: 550 W BURLEIGH BLVD
    TAVARES, FL
    ZIP 32778
  • Phone: (352) 343-1502

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NPI Details

HOLIDAY CVS LLC is a pharmacy in Tavares, 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 1912001868. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #04465.

The provider's business location address is:

550 W BURLEIGH BLVD
TAVARES, FL
ZIP 32778-414
Phone: (352) 343-1502
Fax: (352) 343-0723

The provider's authorized official is Susan F 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 10D2259259 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscv2 30mcg trs-sucr 1 (HCPCS:0051A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
  • Administration of pneumococcal vaccine (HCPCS:G0009)

The enumeration date for this NPI number is 9/12/2006 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
2333600000XPharmacy20434FLORIDAYes

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
1105563100MEDICAIDFLORIDA
25140820435MEDICARE NSC
31064966OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
4BC034MEDICARE PIN
5P00754232OTHERMEDICARE RR

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: 3/30/2025

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