GARFIELD BEACH CVS LLC (NPI# 1164467064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164467064 |
| Entity Type | Organization |
| Organization Name | GARFIELD BEACH CVS LLC |
| Other Organization Name | CVS PHARMACY 09779 |
| Practice Address |
74955 Us Highway 111 Indian Wells CA 92210-7136 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7603464464 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2014-06-02 |
| Authorized Official Name | CRISTIANA MAURICIO (MANAGER PHARMACY ENROLLMENTS) |
| Authorized Official Telephone | 4017702937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5621277 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY 09779 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1386276400 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 8900 S Sepulveda Blvd, Los Angeles, CA 90045-3604 | 2020-02-06 |
| 1366074676 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 415 S La Brea Ave, Los Angeles, CA 90036-3523 | 2020-02-05 |
| 1750912226 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1610 Wilshire Blvd, Santa Monica, CA 90403-5508 | 2020-02-03 |
| 1306477864 | Garfield Beach Cvs LLC | Pharmacy | 1982 Old Mission Dr, Solvang, CA 93463-2304 | 2020-02-03 |
| 1073144531 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 3968 Missouri Flat Rd, Placerville, CA 95667-5240 | 2020-02-03 |
| 1689214744 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 N Broadway # B101, Los Angeles, CA 90012-4700 | 2020-01-07 |
| 1225688138 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 500 Wilshire Blvd, Santa Monica, CA 90401-1404 | 2019-09-13 |
| 1093363483 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 2650 Broadway, Oakland, CA 94612-3190 | 2019-08-28 |
| 1235787714 | Garfield Beach Cvs LLC | Pharmacy | 14310 Hawthorne Blvd, Lawndale, CA 90260-1515 | 2019-08-28 |
| Street Address |
74955 US HIGHWAY 111 |
| City | INDIAN WELLS |
| State | CA |
| Zip Code | 92210-7136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831743012 | Tran Nguyen | Pharmacist | 74955 Us Highway 111, Indian Wells, CA 92210-7136 | 2019-07-26 |
| 1790235992 | Simon Philip Shah | Pharmacist | 74955 Us Highway 111, Indian Wells, CA 92210-7136 | 2016-10-11 |
| 1457704876 | Sherril Davidow | Pharmacist | 74955 Us Highway 111, Indian Wells, CA 92210-7136 | 2016-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750579348 | Linda Mak, Md, Inc. | Dermatology | 74-900 Hwy 111, Ste 212, Indian Wells, CA 92210 | 2007-10-09 |
| 1639372162 | Gary R Smith | Chiropractor | 74-967 Hwy 111, Indian Wells Chiropractic Clinic, Indian Wells, CA 92210 | 2007-06-11 |
| 1477696813 | Richard Stephen Donley | Chiropractor | 74967 Highway 111, Indian Wells, CA 92210 | 2007-02-15 |
| 1689746125 | Frank Warren Gustafson | Physical Therapist | 45240 Club Drive, Indian Wells, CA 92210 | 2006-11-13 |
| 1891899373 | Matthew F Gutowicz Jr. | Radiology | 74785 Highway 111 Suite V101 Wall St West Bldg, Indian Wells, CA 92210 | 2006-09-12 |
| 1407959455 | Emergency Physicians Medical Group Inc | Emergency Medicine | 74785 Highway 111, Suite 100, Indian Wells, CA 92210 | 2006-09-06 |
| 1033169339 | Adam James Brochert | Radiology | 74785 Us Highway 111 Ste 101, Indian Wells, CA 92210 | 2006-05-10 |
| 1801181961 | Executive Urgent Care of Indian Wells | Clinic/Center | 74785 Highway 111, Suite 100, Indian Wells, CA 92210 | 2011-06-16 |
| 1801093844 | Frank Conyngham Crawford II | Dentist | 74-900 Hwy 111, Suite 210, Indian Wells, CA 92210 | 2007-07-02 |
| 1942358320 | Richard Vandyke Packard | Optometrist | 74927 Us Highway 111, Indian Wells, CA 92210 | 2007-01-08 |
| Find all providers in zip 92210 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
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| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN WELLS |
| Zip Code | 92210 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.