Provider Information for 1104860477
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GARFIELD BEACH CVS LLC
Other Names:Doing Business As:CVS PHARMACY 09561Organization Subpart: NO
NPI: 1104860477
Last Updated: 2011-08-24
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Details
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NPI | 1104860477 | ||||||||||||
Enumeration Date | 2006-06-16 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: SUSAN COLBERT Title: DIRECTOR PAYER RELATIONS Phone: 4017702751 | ||||||||||||
Mailing Address | 1 CVS DR PO BOX 1075 WOONSOCKET, RI 02895-6146 United States Phone: | Fax: | ||||||||||||
Primary Practice Address | 17625 HARVARD AVE IRVINE, CA 92614-8547 United States Phone: 949-261-5690 | Fax: | ||||||||||||
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