Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS Pharmacy #10614
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
812 S GRAND AVE, LOS ANGELES, CA 90017-4610
(213) 627-7925
Mailing address
BOX 1075- 1 CVS DR, PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5541620749
MEDICARE NSC
CA
01
—
5662297
NDPDP
—
Enumeration date
02/07/2017
Last updated
06/01/2017
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