MEDICARE: GARFIELD BEACH CVS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy

General Provider Information

NPI Number	:	1104337898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARFIELD BEACH CVS LLC

Provider Business Mailing Address
First Line	:	1 CVS DRIVE
Second Line	:	BOX 1075
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3208 E FLORENCE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5832
Country	:	US
Telephone Number	:	323-589-1916
Fax Number	:

Authorized Official
Title or Position	:	SR DIRECTOR PAYER RELATIONS
Name	:	SUSAN F COLBERT
Credential	:
Telephone Number	:	401-765-1500

Provider Enumeration Date	:	10/20/2017
Last Update Date	:	03/24/2023

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