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Provider Information for 1700808599


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GARFIELD BEACH CVS LLC

Other Names:  
Doing Business As: 
CVS PHARMACY #16473

Organization Subpart: NO

NPI: 1700808599
Last Updated: 2017-06-15
Certification Date:

Details

NameValue
NPI1700808599
Enumeration Date2006-07-24
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: SUSAN COLBERT
Title: Sr. Director, Payer Relations
Phone: 4017702751
Mailing Address 1 CVS DR
BOX 1075
WOONSOCKET, RI 02895-6146
United States

Phone: 401-765-1500 | Fax:
 
Primary Practice Address 2700 BELL RD
AUBURN, CA 95603-2508
United States

Phone: 530-889-2766 | Fax:530-889-2766
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCA1700808599
Other (non-Medicare)1995983PK
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 3336C0003X - Pharmacy - Community/Retail PharmacyCAPHY54026
Yes 333600000X - Pharmacy