Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS PHARMACY #05483
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
5601 VAN NUYS BLVD, SHERMAN OAKS, CA 91401-4603
(818) 781-0569
Mailing address
1 CVS DR, BOX 1075 - PHARMACY ENROLLMENTS, 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
05
—
1881957900
—
CA
01
—
5644340
NCPDP
—
01
—
PHY51008
STATE LICENSE NUMBER
CA
Enumeration date
06/22/2012
Last updated
04/10/2013
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