Organization · NPI-2

Garfield Beach Cvs LLC

Pharmacy · Roseville, CA

NPI number1902104722

StatusActive

Last updated in NPPESJan 31, 2021

Details

NPI: 1902104722
Entity type: Organization (NPI-2)
Legal business name: Garfield Beach Cvs LLC
Organization subpart: No
Enumeration date: Mar 2, 2011
Certification date: Jan 28, 2021
Last updated: Jan 31, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
333600000X	Pharmacy	–	–	Yes
332B00000X	Durable Medical Equipment & Medical Supplies	–	–
3336C0003X	Pharmacy, Community/Retail Pharmacy	–	–

Other names

Cvs Pharmacy #05091 (Doing Business As)

Practice location

1771 Pleasant Grove Blvd
Suite 100
Roseville, CA 95747-8720

Phone 916-772-2239

Mailing address

1 Cvs Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146

Phone 401-765-1500

Authorized official

Susan F Colbert
Director Payer Relations
4017651500

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