NPIMap

Organization Active NPI

Garfield Beach CVS, L.L.C.

  • Pharmacy
  • La Quinta, CA
National Provider Identifier
1497982920
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
GARFIELD BEACH CVS, L.L.C.
Practice address
44-075 Jefferson St.
La Quinta, CA 92253
Phone
(760) 772-2969
NPI assigned
Jun 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan F Colbert
Title
Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

44-075 Jefferson St.
La Quinta, CA 92253

Mailing address

1 CVS Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
5634731OtherNCPDP
1497982920MedicaidCA

Other names 1

  • CVS Pharmacy #03341 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080117000218 CA Part B Supplier - Mass Immunization (Roster Biller Only) 5799866620 This NPI is an additional NPI on the enrollment
O20100930087421 CA DME Supplier - Pharmacy 5799866620 Practice locations: La Quinta, CA

National Provider Directory

National Provider Directory
Tax ID family
CVS Pharmacy 09583721 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1497982920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075 - PHARMACY ENROLLMENTS",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44-075 JEFFERSON ST.",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "92253",
            "telephone_number": "760-772-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARFIELD BEACH CVS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "NCPDP",
            "identifier": "5634731",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497982920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #03341",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.