Garfield Beach CVS LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

GARFIELD BEACH CVS LLC

Doing business as

CVS Pharmacy #09664

Practice address

1564 W Base Line St
San Bernardino, CA 92411-1712

Phone

(909) 381-6944

NPI assigned

Jun 16, 2006

Organization subpart

No

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

Authorized official

Name

Susan Colbert

Title

Director, Payer Relations

Phone

(401) 770-2751

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• CVS PHARMACY #09664 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member of 1

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

• CVS Pharmacy Inc

  dba CVS Pharmacy #07413

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

Locations

Practitioners 4

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

• Adrian Aldasoro, PHARMD

  • Pharmacist
  • San Bernardino, CA
  • NPI 1447606090
  NPD (past)
• Anshul Kumar, PHARMACIST

  • Pharmacist
  • San Bernardino, CA
  • NPI 1972959245
  NPD (past)
• Oanh Lam

  • Pharmacist
  • San Bernardino, CA
  • NPI 1053959833
  NPD (past)
• Jonathan Lim Meas

  • Pharmacist
  • San Bernardino, CA
  • NPI 1417595190
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292976000000",
    "number": "1861436222",
    "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",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1564 W BASE LINE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111712",
            "telephone_number": "909-381-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARFIELD BEACH CVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-12-22",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "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": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5618939",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #09664",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• April Gardner
• Melanie Mannix Gardner, MFTI
• Savannah Rose Gardner
• Syerra Faye Gardner
• Garfield Beach CVS LLC (CVS Pharmacy #09794)
• Garfield Beach CVS LLC (CVS Pharmacy #16042)
• Elizabeth Garibay
• Ava Yvette Garner
• Naomi Garnica
• Anthony D Garrett

• Pharmacy in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.