GARFIELD BEACH CVS LLC (NPI# 1790933794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790933794 |
| Entity Type | Organization |
| Organization Name | GARFIELD BEACH CVS LLC |
| Other Organization Name | CVS PHARMACY #17477 |
| Practice Address |
1363 W Henderson Ave Porterville CA 93257-1456 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5597192204 |
| Practice Fax Number | 5597192214 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2016-11-18 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY54121 | CA | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2116787 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17477 | 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 |
1363 W HENDERSON AVE |
| City | PORTERVILLE |
| State | CA |
| Zip Code | 93257-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548800188 | Giovanni Radhamez Gonzalez Jr. | Pharmacist | 1363 W Henderson Ave, Porterville, CA 93257-1456 | 2020-01-12 |
| 1750936159 | Mohamed Soliman | Pharmacist | 1363 W Henderson Ave, Porterville, CA 93257-1456 | 2019-08-03 |
| 1659776219 | Douangdara Lor | Pharmacist | 1363 W Henderson Ave, Porterville, CA 93257-1456 | 2014-10-24 |
| 1528311305 | Thanh Van Thi Phan | Pharmacist | 1363 W Henderson Ave, Porterville, CA 93257-1456 | 2012-10-18 |
| 1851685648 | Gerald Dennis Nagata | Pharmacist | 1363 W Henderson Ave, Porterville, CA 93257-1456 | 2011-06-08 |
| 1811281736 | Thomas Allan Woodman | Pharmacist | 1363 W Henderson Ave, Porterville, CA 93257-1456 | 2011-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140727 | Marilu Lemos | Student in an Organized Health Care Education/Training Program | 1055 W. Henderson Ave, Suite 2, Porterville, CA 93257 | 2020-06-30 |
| 1497376875 | Monica Kistler | Nurse Practitioner | 65 N Hockett St, Porterville, CA 93257 | 2020-04-27 |
| 1639704182 | Ria Mehta | Occupational Therapist | Sierra Valley Rehab Center, 301 W Putnam Avenue, Porterville, CA 93257 | 2020-03-05 |
| 1659928653 | Jennifer Ramirez | Technician | 1166 San Carlos St, Porterville, CA 93257 | 2019-08-23 |
| 1053875484 | Family Healthcare Network | Clinic/Center | 65 N. Hockett St., Porterville, CA 93257 | 2019-01-30 |
| 1679065189 | William Vanlandingham | Health Educator | 333 W Henderson Ave, Porterville, CA 93257 | 2018-05-31 |
| 1982111209 | Samantha Kaitlyn Crowley | Counselor | 117 W Henderson Ave Ste 1, Porterville, CA 93257 | 2018-01-08 |
| 1538688023 | Jason Reyes | Physician Assistant | 305 E Poplar Ave, Porterville, CA 93257 | 2017-09-15 |
| 1790223790 | Adrian Zamora | Psychiatric Hospital | 1569 Michael Place, Porterville, CA 93257 | 2017-02-09 |
| 1467998849 | Justine Hallas | Nurse Practitioner | 590 Putnam Ave, Porterville, CA 93257 | 2017-01-10 |
| Find all providers in zip 93257 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184083644 | Porterville Pharmacy Inc | Pharmacy | 406 W Putnam Ave, Porterville, CA 93257-3321 | 2016-02-12 |
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| 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 |
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| 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 | PORTERVILLE |
| Zip Code | 93257 |
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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.