Garfield Beach CVS LLC
Organization Active NPI Pharmacy · Tiburon, CA
NPI 1891065447 · NPPES record last updated Oct 1, 2012
Key facts
- NPI
- 1891065447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- GARFIELD BEACH CVS LLC
- Practice address
- 1599 Tiburon Blvd
Tiburon, CA 94920-2525 - Phone
- (415) 435-3843
- NPI assigned
- Jan 12, 2012
- Organization subpart
- No
Authorized official
- Name
- Susan F Colbert
- Title
- Director Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Practitioners 9
-
Ariel Chu Dunn, PHARMD
-
Rina Houri, RPH
-
Michael A Lim, RPH
-
Teresa Zhen, PHARM.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2268807 | CVS/Pharmacy #01483 | Certificate of waiver | Sep 15, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #01483 |
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Medicare enrollment records
| 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 |
| O20120517000113 | CA | DME Supplier - Pharmacy | 5799866620 | Practice locations: Tiburon, CA |
National Provider Directory
- Tax ID family
- CVS Pharmacy 09583
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1599 Tiburon Blvd
Tiburon, CA 94920-2525
Mailing address
1 CVS Dr
Box 1075 - Pharmacy Enrollments
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891065447 | Medicaid | CA | |
| 5642740 | Other | NCPDP |
Other names
- CVS PHARMACY #01483
Other providers in Tiburon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.