Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS PHARMACY #09664
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1564 W BASE LINE ST, SAN BERNARDINO, CA 92411-1712
(909) 381-6944
Mailing address
1 CVS DR, PO 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
—
5618939
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/16/2006
Last updated
12/22/2010
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