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NPI Code Detail

MEDICARE: GARFIELD BEACH CVS LLC

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 License Number License Number State
13336C0003XCommunity/Retail PharmacyPHY54183CA
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22114973OTHERPK

General Provider Information

NPI Number : 1104867142
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARFIELD BEACH CVS LLC
Provider Business Mailing Address
First Line : 1 CVS DR
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 : 3155 SILVER CREEK RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95121-1730
Country : US
Telephone Number : 408-238-6070
Fax Number : 408-620-3001
Authorized Official
Title or Position : SR. DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 06/09/2006
Last Update Date : 01/25/2017

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Directions to “GARFIELD BEACH CVS LLC ” Practice Location

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