HOLIDAY CVS, L.L.C.
NPI: 1639407596
· PORT CHARLOTTE, FL 33980
· Durable Medical Equipment & Medical Supplies
· NPI assigned 12/03/2009
$116.64
Total Medicaid Paid
Provider Details
| Authorized Official | COLBERT, SUE (DIRECTOR, MANAGED CARE) |
| NPI Enumeration Date | 12/03/2009 |
Related Entities
Other providers sharing the same authorized official: COLBERT, SUE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
111 |
$116.64 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0004A |
|
31 |
20 |
$116.64 |
| 0002A |
|
32 |
29 |
$0.00 |
| 0001A |
|
48 |
41 |
$0.00 |