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HOLIDAY CVS LLC NPI 1205930161


NPI Information

NPI: 1205930161
Provider Name: HOLIDAY CVS LLC

Doing Business As: CVS PHARMACY 05171

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
1005 OHIO AVE S
LIVE OAK, FL
ZIP 32064
Phone: (386) 362-5183
Get Directions

HOLIDAY CVS LLC is a pharmacy in Live Oak, 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 1205930161. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy 05171.

The provider's business location address is:

1005 OHIO AVE S
LIVE OAK, FL
ZIP 32064-129
Phone: (386) 362-5183
Fax: (386) 362-4887

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

The enumeration date for this NPI number is 9/12/2006 and was last updated on 11/21/2012.


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
1332B00000XDurable Medical Equipment & Medical SuppliesFLORIDANo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy20700FLORIDAYes

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
1BC034CMEDICARE PIN
2105942400MEDICAIDFLORIDA
35140820479MEDICARE NSC
4P00949650MEDICARE PINFLORIDA
51079169OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

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

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