Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS Pharmacy #17515
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
51 TIERRA REJADA RD, SIMI VALLEY, CA 93065-2902
(805) 416-5791
(805) 416-5792
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
PHY54119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720393085
—
CA
01
—
2126172
PK
—
Enumeration date
08/11/2010
Last updated
06/02/2017
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