Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS PHARMACY #03825
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
303 S LA BREA AVE, LOS ANGELES, CA 90036-3526
(323) 634-0743
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENT, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY51073
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558619395
—
CA
01
—
5645861
NCPDP
—
Enumeration date
08/28/2012
Last updated
07/02/2013
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