Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS PHARMACY #17719
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4211 EAGLE ROCK BLVD, LOS ANGELES, CA 90065-4404
(323) 340-1435
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5663263
NCPDP
—
Enumeration date
05/12/2017
Last updated
10/10/2017
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