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CVS PHARMACY 05115
NPI 1790889657
Pharmacy in Davie, FL

Active since September 12, 2006CLIA 10D2227529 · Waiver
2920 SW 64TH AVE, DAVIE, FL 33314(954) 584-8059(954) 327-0116 Get Directions Write a Review

NPPES record last updated: December 7, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Cvs Pharmacy 05115 NPPES

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

CVS PHARMACY 05115 (NPI 1790889657) is a healthcare organization registered as a pharmacy in Davie, Florida and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through June 13, 2027 and lists Cristiana Mauricio, Mgr Phcy Enrollments, as its authorized official.

NPPES Registry Identity

NPI1790889657
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameHOLIDAY CVS LLC
Location Address2920 SW 64TH AVEDavie, FL 33314-1601
Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146
Phone(954) 584-8059
Fax(954) 327-0116
Organization SubpartNo
Authorized OfficialCristiana MauricioMgr Phcy Enrollments · (401) 770-2937
Enumeration DateSeptember 12, 2006
Last NPPES UpdateDecember 7, 2009
✔ NPI 1790889657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in FL · 20589
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
2920 SW 64TH AVE, Davie, FL 33314
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Other Names 1

Doing Business AsCvs Pharmacy 05115

Other Identifiers 4

Other1075678Other Id Number-commercial Number
Medicaid105725100FL
Medicare NSC5140820466
Medicare PINBC034A

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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2227529

Holiday CVS LLC Dba Cvs/Pharmacy #5115 · Davie, FL
Active · expires Jun 13, 2027
CLIA Number10D2227529
Laboratory TypePharmacy
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorDana Fisher
Laboratory Phone(954) 584-8059
Laboratory LocationHoliday CVS LLC Dba Cvs/Pharmacy #51152920 Davie Rd, Davie, FL 33314
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.

Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count K1034
This service provides a FDA-approved COVID-19 test kit for personal use. The test is self-administered and self-collected, meaning you conduct the test yourself. The kit contains all necessary items for one test. Follow the instructions carefully to ensure accurate results.
264 services30 patients
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.
33 services33 patients
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage 90694
The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
30 services30 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #05115 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #05115

DMEPOS supplier · Davie, FLOperated by Holiday CVS LLC
✔

Accepts Medicare assignment

CVS Pharmacy #05115 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)20424983
Medicare Participant SinceJanuary 1, 2019
Supplier Location2920 Davie RdDavie, FL 33314
Phone(954) 584-8059
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.

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 1790889657. It was assigned to this organization in the NPPES registry on September 12, 2006.

Where is Holiday CVS LLC located?

Holiday CVS LLC is located at 2920 SW 64th Ave, Davie, FL 33314. The listed phone number is (954) 584-8059.

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 #05115 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Holiday CVS LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2227529) is associated with this NPI, valid through June 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 34 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 December 7, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.