GARFIELD BEACH CVS LLC (NPI# 1841536463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841536463 |
| Entity Type | Organization |
| Organization Name | GARFIELD BEACH CVS LLC |
| Other Organization Name | CVS PHARMACY #17586 |
| Practice Address |
401 Kenilworth Dr Petaluma CA 94952-3400 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7077756323 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2017-01-19 |
| 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 |
PHY54104 | CA | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1841536463 | 05 | |
| PK | 2138368 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17586 | 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 |
401 KENILWORTH DR |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043507627 | Thomas Randall Szutz | Dentist | 401 Kenilworth Dr, Suite 960, Petaluma, CA 94952-3400 | 2011-07-05 |
| 1003352030 | Kristi Rose Lim Wong | Pharmacist | 401 Kenilworth Dr, Petaluma, CA 94952-3400 | 2017-01-14 |
| 1609226315 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 401 Kenilworth Dr, Petaluma, CA 94952-3400 | 2016-06-14 |
| 1619344918 | Darwin C Tsang | Optometrist | 401 Kenilworth Dr, Inside Target Optical, Petaluma, CA 94952-3400 | 2015-08-21 |
| 1932518164 | Melissa Ann Styles | Dentist | 401 Kenilworth Dr, Suite 960, Petaluma, CA 94952-3400 | 2014-08-13 |
| 1043628951 | Lauren Ashley Louie | Pharmacist | 401 Kenilworth Dr, Petaluma, CA 94952-3400 | 2014-07-24 |
| 1699191759 | Humara Anwar | Pharmacist | 401 Kenilworth Dr, T-2601, Petaluma, CA 94952-3400 | 2014-03-13 |
| 1679909196 | Nicholas Robert Lau | Pharmacist | 401 Kenilworth Dr, Petaluma, CA 94952-3400 | 2013-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| 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 |
|---|---|---|---|---|
| 1841237500 | Lucky Stores II LLC | Pharmacy | 939 Lakeville Hwy, Petaluma, CA 94952-3329 | 2006-06-01 |
| 1942202031 | Professional Pharmacies, Inc | Pharmacy | 300 Washington St, Petaluma, CA 94952-2915 | 2005-08-10 |
| 1548689961 | Marin Apothecaries Inc | Pharmacy | 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | 2014-04-14 |
| 1568519882 | Kaiser Foundation Health Plan Inc | Pharmacy | 3900 Lakeville Hwy, Petaluma, CA 94954-5698 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
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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.