1. Home
  2. Directory
  3. Florida
  4. Bonita Springs
  5. Pharmacy
  6. NPI Profile

CVS PHARMACY 05787
NPI 1922102847
Pharmacy in Bonita Springs, FL

Active since September 12, 2006CLIA 10D2227885 · Waiver
11500 BONITA BEACH RD SE, BONITA SPRINGS, FL 34135(239) 498-6395 Get Directions Write a Review

NPPES record last updated: March 19, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Cvs Pharmacy 05787 NPPES

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

CVS PHARMACY 05787 (NPI 1922102847) is a healthcare organization registered as a pharmacy in Bonita Springs, Florida and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through June 17, 2027 and lists Susan Colbert, Director Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1922102847
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameHOLIDAY CVS LLC
Location Address11500 BONITA BEACH RD SEBonita Springs, FL 34135-5999
Mailing Address1 Cvs Dr, Po Box 1075Woonsocket, RI 02895-6146
Phone(239) 498-6395
Organization SubpartNo
Authorized OfficialSusan ColbertDirector Payer Relations · (401) 770-2751
Enumeration DateSeptember 12, 2006
Last NPPES UpdateMarch 19, 2012
✔ NPI 1922102847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in FL · PH19229
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
11500 BONITA BEACH RD SE, Bonita Springs, FL 34135
Open in Google Maps ↗

Other Names 1

Doing Business AsCvs Pharmacy 05787

Other Identifiers 4

Medicare PINP00949648
Other1098640Other Id Number-commercial Number
Medicare PINBC034AFL
Medicare NSC5140820600

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 10D2227885

Holiday CVS, LLC Dba CVS Pharmacy #5787 · Bonita Springs, FL
Active · expires Jun 17, 2027
CLIA Number10D2227885
Laboratory TypePharmacy
Certificate Effective DateJune 18, 2025
Certificate Expiration DateJune 17, 2027
Laboratory DirectorLoodane Chayaud
Laboratory Phone(239) 498-6395
Laboratory LocationHoliday CVS, LLC Dba CVS Pharmacy #578711500 Bonita Beach Rd SE, Bonita Springs, FL 34135
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

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.
554 services553 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.
365 services365 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.
162 services162 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.
53 services53 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.
49 services49 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.
20 services20 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #05787 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #05787

DMEPOS supplier · Bonita Springs, FLOperated by Holiday CVS LLC
✔

Accepts Medicare assignment

CVS Pharmacy #05787 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)20426393
Medicare Participant SinceJanuary 1, 2019
Supplier Location11500 Bonita Beach Rd SEBonita Springs, FL 34135
Phone(239) 498-6395
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.

RAJU RAJAN RPH
Pharmacist
11500 BONITA BEACH RD SE
BONITA SPRINGS, FL 34135
Lee County (239) 498-6395
JAMIL RASUL
Pharmacist
11500 BONITA BEACH RD SE
BONITA SPRINGS, FL 34135
Lee County (239) 498-6593

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 1922102847. 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 11500 Bonita Beach Rd SE, Bonita Springs, FL 34135. The listed phone number is (239) 498-6395.

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 #05787 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 10D2227885) is associated with this NPI, valid through June 17, 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 March 19, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.