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Provider Information for 1447295340


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GARFIELD BEACH CVS LLC

Other Names:  
Doing Business As: 
CVS PHARMACY #09610

Organization Subpart: NO

NPI: 1447295340
Last Updated: 2009-09-11
Certification Date:

Details

NameValue
NPI1447295340
Enumeration Date2006-06-17
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: CRISTIANA MAURICIO
Title: MANAGER PHARMACY ENROLLMENTS
Phone: 4017702937
Mailing Address 1 CVS DR
PO BOX 1075
WOONSOCKET, RI 02895-6146
United States

Phone: | Fax:
 
Primary Practice Address 12280 PERRIS BLVD
MORENO VALLEY, CA 92557-7418
United States

Phone: 951-242-3596 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)5621138Other ID Number-Commercial Number
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 3336C0003X - Pharmacy - Community/Retail Pharmacy
Yes 333600000X - Pharmacy