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Garfield Beach CVS LLC

Organization Active NPI Pharmacy · Murrieta, CA

NPI 1518192541 · NPPES record last updated Nov 18, 2016

Key facts

NPI
1518192541
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
Legal business name
GARFIELD BEACH CVS LLC
Practice address
27818 Clinton Keith Rd
Murrieta, CA 92562-8554
Phone
(951) 704-1124
Fax
(951) 704-1134
NPI assigned
May 20, 2009
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #17545
27818 Clinton Keith Rd, Murrieta, CA 92562-8554 · (951) 704-1124		 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… Does not accept assignment
Participating since Jan 1, 2019

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080117000218 CA Part B Supplier - Mass Immunization (Roster Biller Only) 5799866620 This NPI is an additional NPI on the enrollment
O20160921000078 CA DME Supplier - Pharmacy 5799866620 Practice locations: Murrieta, CA

National Provider Directory

Tax ID family
CVS Pharmacy 09583 (721 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Yes
Community/Retail Pharmacy 3336C0003X PHY54192 CA

Addresses

Primary practice location

27818 Clinton Keith Rd
Murrieta, CA 92562-8554

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
2120072OtherPK

Other names

  • CVS Pharmacy #17545 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 18, 2016.

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1518192541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "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": "27818 CLINTON KEITH RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628554",
            "telephone_number": "951-704-1124",
            "fax_number": "951-704-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARFIELD BEACH CVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. 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": "CA",
            "license": "PHY54192",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120072",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #17545",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

All providers in Murrieta, CA · Pharmacy in California

Sources for this page

Verify at the official NPI Registry.