Organization
GARFIELD BEACH CVS LLC
Active
Other names
CVS PHARMACY #05091
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1771 PLEASANT GROVE BLVD, SUITE 100, ROSEVILLE, CA 95747-8720
(916) 772-2239
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
—
1902104722
—
CA
01
—
5640354
NCPDP
—
01
—
P00754218
MEDICARE - RR PIN
—
Enumeration date
03/02/2011
Last updated
01/31/2021
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