Active NPI
Garfield Beach CVS LLC
Doing business as CVS Pharmacy
- Pharmacy
- Reseda, CA
National Provider Identifier
1407897317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- GARFIELD BEACH CVS LLC
- Doing business as
- CVS Pharmacy
- Practice address
- 18247 Sherman Way
Reseda, CA 91335-4551 - Phone
- (818) 345-9640
- NPI assigned
- Jun 10, 2006
- Last updated
- Aug 26, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Manager Pharmacy Enrollments
- Phone
- (401) 770-2937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
18247 Sherman Way
Reseda, CA 91335-4551
Mailing address
1 CVS Dr
PO Box 1075
Woonsocket, RI 02895-6146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5620035 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080117000218 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 5799866620 | This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
18247 Sherman Way
Reseda, CA 91335
Phone (818) 345-9640
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Reseda, CA
- NPI 1144685116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1314316800000",
"number": "1407897317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "PO BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18247 SHERMAN WAY",
"city": "RESEDA",
"state": "CA",
"postal_code": "913354551",
"telephone_number": "818-345-9640"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARFIELD BEACH CVS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-10",
"last_updated": "2011-08-26",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "MANAGER PHARMACY ENROLLMENTS",
"authorized_official_telephone_number": "401-770-2937"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "5620035",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Reseda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.