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CVS PHARMACY 00411
NPI 1164526141
Pharmacy in Lake Wales, FL

Active since September 12, 2006
500 S 11TH ST, LAKE WALES, FL 33853(863) 676-2564(863) 678-1353 Get Directions Write a Review

NPPES record last updated: January 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cvs Pharmacy 00411 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY 00411 (NPI 1164526141) is a healthcare organization registered as a pharmacy in Lake Wales, Florida and active in the NPI registry since September 2006. The organization lists Susan F Colbert, Director, as its authorized official.

NPPES Registry Identity

NPI1164526141
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameHOLIDAY CVS LLC
Location Address500 S 11TH STLake Wales, FL 33853-4901
Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146
Phone(863) 676-2564
Fax(863) 678-1353
Organization SubpartNo
Authorized OfficialSusan F ColbertDirector · (401) 770-2751
Enumeration DateSeptember 12, 2006
Last NPPES UpdateJanuary 10, 2023
NPPES CertifiedJanuary 10, 2023
✔ NPI 1164526141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in FL · 20675
Definition
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.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
500 S 11TH ST, Lake Wales, FL 33853
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Other Names 1

Doing Business AsCvs Pharmacy 00411

Other Identifiers 2

Other1004530Other Id Number-commercial Number
Medicaid105631000FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
216 services212 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
128 services128 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
70 services70 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
40 services40 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
38 services38 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #00411 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #00411

DMEPOS supplier · Lake Wales, FLOperated by Holiday CVS LLC
✔

Accepts Medicare assignment

CVS Pharmacy #00411 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20436689
Medicare Participant SinceJanuary 1, 2019
Supplier Location500 S 11th StLake Wales, FL 33853
Phone(763) 676-2564
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANU CHETTICHERIL RAJU
Pharmacist
500 S 11TH ST
LAKE WALES, FL 33853
Polk County (863) 676-2564
SUDHAKAR PINNAMANENI
Pharmacist
500 S 11TH ST
LAKE WALES, FL 33853
Polk County (863) 676-2564

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holiday CVS LLC's NPI number?

The NPI number for Holiday CVS LLC is 1164526141. It was assigned to this organization in the NPPES registry on September 12, 2006. The provider is doing business as CVS Pharmacy 00411.

Where is Holiday CVS LLC located?

Holiday CVS LLC is located at 500 S 11th St, Lake Wales, FL 33853. The listed phone number is (863) 676-2564.

What is Holiday CVS LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Holiday CVS LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #00411 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Holiday CVS LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 35 other insurers list Holiday CVS LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Holiday CVS LLC was last updated on January 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.