Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS Pharmacy #17619
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
11990 LOS OSOS VALLEY RD, SAN LUIS OBISPO, CA 93405-6861
(805) 585-9903
(805) 585-9913
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY54093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114211612
—
CA
01
—
2130465
PK
—
Enumeration date
06/02/2011
Last updated
05/09/2017
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