Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS Pharmacy # 09817
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
31771 RANCHO CALIFORNIA RD, TEMECULA, CA 92591-2997
(951) 699-7587
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY48235
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5623358
COMMERCIAL NUMBER
CA
01
—
P00754218
RAIL ROAD PIN
—
Enumeration date
08/29/2006
Last updated
08/24/2011
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