Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS Pharmacy #17694
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
180 DONAHUE ST, SAUSALITO, CA 94965-1250
(415) 289-0534
Mailing address
1 CVS DR, BOX-1075 - 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
—
5541620748
MEDICARE NSC
CA
01
—
5661827
NCPDP
—
Enumeration date
12/27/2016
Last updated
06/01/2017
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