HOLLY HILL PHARMACY
NPI 1932109667
Pharmacy in Holly Hill, FL
NPI Status: Active since July 22, 2005
Contact Information
1702 RIDGEWOOD AVE
SUITE A - G
HOLLY HILL, FL
ZIP 32117
Phone: (386) 677-7377
Fax: (386) 677-0739
- Organization
- Pharmacy
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 10D2132139
- CLIA Cert. Type: Home Health Agency
- CLIA Exp. Date: 06-12-2027
About HOLLY HILL PHARMACY
This page provides the complete NPI Profile along with additional information for Holly Hill Pharmacy, a provider established in Holly Hill, Florida operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1932109667 assigned on July 2005. The practitioner's primary taxonomy code is 333600000X with license number PH 9050 (FL). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Holly Hill Pharmacy. The authorized official of this NPI record is Thomas Hill Pharmd (Dpt)
- NPI
- 1932109667
- Provider Legal Name
- XINIM CORPORATION
- Other Organization Name
- HOLLY HILL PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1702 RIDGEWOOD AVE SUITE A - G HOLLY HILL, FL 32117
- Location Phone
- (386) 677-7377
- Location Fax
- (386) 677-0739
- Mailing Address
- 1702 RIDGEWOOD AVE SUITE C HOLLY HILL, FL 32117
- Mailing Phone
- (386) 677-7377
- Mailing Fax
- (386) 677-0739
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-22-2005
- Last Update Date
- 04-19-2021
- Code Navigator
Holly Hill Pharmacy is a medicare supplier with PTAN 20406377 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Blood Glucose Monitors/Supplies (Non-Mail Order) or External Infusion Pumps and/or Supplies or Ostomy Supplies or Urological Supplies or Parenteral Nutrients or Parenteral Equipment and/or Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- License No.
- PH 9050
- License State
- FL
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251E00000X | Agencies | Home Health | 299994706 (FL) |
| 2 | 251F00000X | Agencies | Home Infusion | |
| 3 | 261QI0500X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | PH9050 (FL) |
| 5 | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | PH9050 (FL) |
| 6 | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | PH9050 (FL) |
| 7 | 3336H0001X | Suppliers | Pharmacy | PH9050 |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 8500 for HSA - HMO
- Anthem Bronze Pathway Essentials 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway Essentials 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway Essentials 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- ConnectPlus $0 Gold - PPO
- ConnectPlus $0 Silver - PPO
- ConnectPlus $10,600 HSA Eligible HDHP - PPO
- ConnectPlus $1800 - PPO
- ConnectPlus $4500 - PPO
- ConnectPlus $6500 HSA Eligible HDHP - PPO
- ConnectPlus $7500 HSA Eligible HDHP - PPO
- ConnectPlus MyWeighForward $2000 - PPO
- ConnectPlus MyWeighForward $6000 - PPO
- ConnectPlus Standard $2000 - PPO
- ConnectPlus Standard $6000 - PPO
- ConnectPlus Standard $7500 HSA Eligible HDHP - PPO
- DirectConnect $0 Gold - HMO
- DirectConnect $0 Silver - HMO
- DirectConnect $1800 - HMO
- DirectConnect $4500 - HMO
- DirectConnect $6500 HSA Eligible HDHP - HMO
- DirectConnect $7500 HSA Eligible HDHP - HMO
- DirectConnect MyWeighForward $2000 - HMO
- DirectConnect MyWeighForward $6000 - HMO
- BSW Diabetes Care Gold HMO 014 - HMO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Savers Bronze HMO H S A 009 - HMO
- Blue KC Catastrophic BlueSelect EPO - EPO
- Blue KC Choice Bronze 2 with Spira Care BlueSelect EPO - EPO
- Blue KC Choice Silver 1 with Spira Care BlueSelect EPO - EPO
- Blue KC Community Silver Preferred-Care Blue EPO - EPO
- Blue KC First Bronze Preferred-Care Blue EPO - EPO
- Blue KC Simply Blue Bronze with Spira Care Blue Metro EPO - EPO
- Blue KC Simply Blue Gold with Spira Care Blue Metro EPO - EPO
- Blue KC Simply Blue Silver with Spira Care Blue Metro EPO - EPO
- Blue KC Standard Bronze BlueSelect EPO - EPO
- Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
- Blue KC Standard Gold BlueSelect EPO - EPO
- Blue KC Standard Gold Preferred-Care Blue EPO - EPO
- Blue KC Standard Silver BlueSelect EPO - EPO
- Blue KC Standard Silver Preferred-Care Blue EPO - EPO
- BlueCross B15E $0 virtual care from Teladoc Health� - EPO
- BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross B17E $0 virtual care from Teladoc Health� + Adult Dental - EPO
- BlueCross B19E $60 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health� + Adult Dental - EPO
- BlueCross S34E $45 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-06 (Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
- BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-05 (Rewards) - POS
- BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-18 (Rewards) - POS
- BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS
- Gym Access IND Bronze HMO 1340 - HMO
- Gym Access IND Bronze HMO OA 1211 - HMO
- Gym Access IND Bronze HMO OA Standard 2450 - HMO
- Gym Access IND Bronze POS 1042 - POS
- Gym Access IND Bronze POS BC 3841 - POS
- Gym Access IND Bronze POS OA 1211 - POS
- Gym Access IND Bronze POS OA Standard 2450 - POS
- Gym Access IND Bronze Standardized HMO - HMO
- Gym Access IND Gold HMO 4500 - HMO
- Gym Access IND Gold HMO BC 5651 - HMO
- Gym Access IND Gold HMO H.S.A 9010 - HMO
- Gym Access IND Gold HMO OA Standard 3450 - HMO
- Gym Access IND Gold POS 55001 - POS
- Gym Access IND Gold POS BC 5651 - POS
- Gym Access IND Gold POS OA Standard 3450 - POS
- Gym Access IND Silver HMO BC 0941 - HMO
- Gym Access IND Silver HMO BC 7741 - HMO
- Gym Access IND Silver HMO OA 1009 - HMO
- Gym Access IND Silver HMO OA Standard 1440 - HMO
- Gym Access IND Silver POS BC 0941 - POS
- Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Standard 1828 - HMO
- Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
- Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
- Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
- Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
- Gold Savings 1825 + Adult Dental + Adult Vision ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
- Gold Standard 1833 - HMO
- Gold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Gold Value 1819 + Adult Dental + Adult Vision ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Gold Value 1819 + Enhanced Diabetes Benefits ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Silver 1664 (Primary Care & Specialist Copays, Open Access) - HMO
- Silver 1664 + Adult Dental + Adult Vision (Primary Care & Specialist Copays, Open Access) - HMO
- Silver Savings 1821 (Primary Care Copay, Open Access) - HMO
- Silver Savings 1821 + Adult Dental + Adult Vision (Primary Care Copay, Open Access) - HMO
- Oak $1,300 Gold - PPO
- Oak $2,000 Standard Gold - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Standard - EPO
- Elevate by Medica Bronze $0 Copay PCP Visits - EPO
- Elevate by Medica Bronze Share - EPO
- Elevate by Medica Expanded Bronze Standard - EPO
- Elevate by Medica Gold $0 Copay PCP Visits - EPO
- Elevate by Medica Gold Share - EPO
- Elevate by Medica Gold Standard - EPO
- Elevate by Medica Silver $0 Copay PCP Visits - EPO
- Elevate by Medica Silver Share - EPO
- Elevate by Medica Silver Standard - EPO
- Inspire by Medica Bronze $0 Copay PCP Visits - EPO
- Inspire by Medica Bronze Share - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
- Molina Bronze Saver 7000 - HMO
- Molina Bronze Saver 7000 Plus with Adult Dental and Vision - HMO
- Molina Bronze Saver 7000 Plus with Adult Vision - HMO
- Molina Bronze Smart Heart Health - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Enhanced 895 - HMO
- Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
- Molina Gold Enhanced 895 Plus with Adult Vision - HMO
- Molina Gold Saver 750 - HMO
- Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
- Molina Gold Saver 750 Plus with Adult Vision - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Elite Saver Plus - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Silver Simple Chronic Care CKM - HMO
- Silver Simple Diabetes - HMO
- Silver Simple PCP Saver - HMO
- Silver Simple Women's Health with Menopause Benefits - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with AdventHealth - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with AdventHealth - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with AdventHealth - HMO
- Gold Elite Saver Plus | with AdventHealth - HMO
- Gold Simple - HMO
- Gold Simple | with AdventHealth - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with AdventHealth - HMO
- Silver Elite - HMO
- Silver Elite | with AdventHealth - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Silver Simple Chronic Care CKM - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with Atrium Health - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with Atrium Health - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with Atrium Health - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health - HMO
- Bronze Simple Chronic Care CKM | with Atrium Health - HMO
- Bronze Simple Diabetes | with Atrium Health - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with Atrium Health - HMO
- Silver Classic - HMO
- Silver Classic | with Atrium Health - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with Atrium Health - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health - HMO
- Silver Simple Chronic Care CKM | with Atrium Health - HMO
- Silver Simple Diabetes - HMO
- Silver Simple Diabetes | with Atrium Health - HMO
- Silver Simple PCP Saver - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Buena Salud Bronce Simple Para Diabetes - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Simple - HMO
- Gold Simple Diabetes - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple - HMO
- Silver Simple Chronic Care CKM - HMO
- Silver Simple Diabetes - HMO
- Silver Simple PCP Saver - HMO
- Silver Simple Specialist Saver with COPD - HMO
- Silver Simple Women's Health with Menopause Benefits - HMO
- Bronze Classic - EPO
- Bronze Classic | with Bryan Health - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard - PPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Classic Standard | with Bryan Health - EPO
- Bronze Elite + PCP Saver - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus - PPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
- Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
- Bronze Simple - EPO
- Bronze Simple - PPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - PPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
- Bronze Simple Chronic Care CKM - EPO
- Bronze Simple Chronic Care CKM - PPO
- Bronze Classic PCP Saver | Cleveland Clinic - HMO
- Bronze Classic Standard | Cleveland Clinic - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
- Bronze Simple Chronic Care CKM | Cleveland Clinic - HMO
- Bronze Simple Diabetes | Cleveland Clinic - HMO
- Bronze Simple HSA | Cleveland Clinic - HMO
- Gold Classic Standard | Cleveland Clinic - HMO
- Gold Elite | Cleveland Clinic - HMO
- Gold Elite Saver Plus | Cleveland Clinic - HMO
- Silver Classic Standard | Cleveland Clinic - HMO
- Silver Elite Saver Plus | Cleveland Clinic - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic - HMO
- Silver Simple Chronic Care CKM | Cleveland Clinic - HMO
- Silver Simple Diabetes | Cleveland Clinic - HMO
- Silver Simple PCP Saver | Cleveland Clinic - HMO
- Silver Simple Women's Health with Menopause Benefits | Cleveland Clinic - HMO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $10,600 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,500 - PPO
- Sanford Individual Simplicity $7,200 HSA Qualified - PPO
- Sanford Individual Simplicity Standardized $2,000 - PPO
- Sanford Individual Simplicity Standardized $6,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $10,600 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,500 - HMO
- Sanford Individual TRUE $7,200 HSA Qualified - HMO
- Sanford Individual TRUE Standardized $2,000 - HMO
- Sanford Individual TRUE Standardized $6,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Bronze 8000 - HMO
- SummaCare Bronze 8000 with Adult Vision Exam - HMO
- SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
- SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 7000 with 3 Free PCP Visits - HMO
- SummaCare Standard Bronze - HMO
- SummaCare Standard Bronze with Adult Vision - HMO
- SummaCare Standard Gold - HMO
- SummaCare Standard Gold with Adult Vision - HMO
- SummaCare Standard Silver - HMO
- SummaCare Standard Silver with Adult Vision - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
- UHC Bronze Essential - HMO
- UHC Bronze Essential- - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - HMO
- Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Catastrophic (+ Incentives) - HMO
- Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 2000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 103813400 | MEDICAID (05) | FL |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20406377
- Accepts Medicare Assignment
- YES
- Specialities List
- Orthotic Personnel, Prosthetic Personnel, Pharmacy.
- Provider Type List
- OXYGEN & EQUIPMENT.
- Competitive Bidding
- NO
Supplies List
- 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
- External Infusion Pumps and/or Supplies - An infusion pump is necessary to safely administer the drug
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Urological Supplies - Catheters, Urinary collection devices
- Parenteral Nutrients - Parenteral nutrient solutions
- Parenteral Equipment and/or Supplies - Parenteral infusion pumps, parenteral nutrition supply kits
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2132139
- Facility Type
- Home Health Agency
- Certificate Effective Date
- June 13, 2025
- Certificate Expiration Date
- June 12, 2027
- Laboratory Director
- ERIC P. GICK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Holly Hill Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1932109667, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Pos 1
1
Pos 2
9
Pos 3
3
Pos 4
2
Pos 5
1
Pos 6
0
Pos 7
9
Pos 8
6
Pos 9
6
Check
7
Regular digit
Doubled digit
Check digit
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
1 → 2
3 → 6
1 → 2
9 → 18 → 9
6 → 12 → 3
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
2 + 9 + 6 + 2 + 2 + 0 + 1 + 8 + 6 + 1 + 2 + 24 = 63
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1932109667.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Clinic/Center (Primary Care)
1702 RIDGEWOOD AVE, SUITE I
HOLLY HILL, FL 32117
HOLLY HILL, FL 32117
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1932109667, enumerated as an "organization" on July 22, 2005.
The provider is located at 1702 RIDGEWOOD AVE SUITE A - G HOLLY HILL, FL 32117 and the phone number is (386) 677-7377.
Pharmacy with taxonomy code 333600000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Antidote Health. Please consult your insurance carrier or call the provider to verify.
