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Export Provider Record NPI 1104920073
Holiday Cvs Llc
Organization Subpart: NO
Active
NPI Number1104920073
NPI TypeNPI-2 Organization
SpecialtyPharmacy
Provider Details
NPI1104920073
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-09-12
Last Updated2012-07-11
Authorized OfficialSusan Colbert
Director
Phone: 4017651500
Mailing Address1 Cvs Dr, Po Box 1075
Woonsocket, RI 02895-6146
United States
📍 View Map
Primary Practice Address3090 W Oakland Park Blvd
Oakland Park, FL 33311-1228
United States
Phone: (954) 717-1848 | Fax: (954) 717-1902
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL106254900-
Other (non-Medicare)-1082053Other ID Number-Commercial Number
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No3336C0003X – Pharmacy, Community/Retail Pharmacy--
No332B00000X – Durable Medical Equipment & Medical Supplies--
Yes333600000X – PharmacyFL20662
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About NPI 1104920073

Holiday Cvs Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104920073. The primary specialty listed is Pharmacy. The organization is located in Oakland Park, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-09-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104920073?

NPI 1104920073 belongs to Holiday Cvs Llc, a Pharmacy in Oakland Park, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104920073 active?

The current status of NPI 1104920073 in the NPPES registry is Active. The record was last updated on 2012-07-11.

What specialty is NPI 1104920073?

NPI 1104920073 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104920073?

You can verify NPI 1104920073 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104920073?

The primary practice address on file for NPI 1104920073 is 3090 W Oakland Park Blvd, Oakland Park, FL 33311-1228. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104920073 issued?

NPI 1104920073 was first issued (enumerated) on 2006-09-12. The NPPES record was last updated on 2012-07-11.

Practice Location Map

Holiday Cvs Llc is located at 3090 W Oakland Park Blvd, Oakland Park, FL. Use the map below to find directions or verify the practice location.

📍 3090 W Oakland Park Blvd, Oakland Park, FL 33311-1228  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Holiday Cvs Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1104920073. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy20662FL
Data Verified from CMS NPPES Last synced: 2026-08-11 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162