GARFIELD BEACH CVS LLC (NPI# 1902104722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902104722 |
Entity Type | Organization |
Organization Name | GARFIELD BEACH CVS LLC |
Other Organization Name | CVS PHARMACY #05091 |
Practice Address |
1771 Pleasant Grove Blvd Suite 100 Roseville CA 95747-8720 |
Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
Practice Telephone | 9167722212 |
Mailing Telephone | 4017651500 |
Enumeration Date | 2011-03-02 |
Last Update Date | 2013-01-23 |
Authorized Official Name | SUSAN F COLBERT (DIRECTOR PAYER RELATIONS) |
Authorized Official Telephone | 4017651500 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
Y | 333600000X | Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP | 5640354 | 01 | |
MEDICARE - RR PIN | P00754218 | 01 | |
CA | 1902104722 | 05 |
Other Name | Type Code |
---|---|
CVS PHARMACY #05091 | 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 |
1771 PLEASANT GROVE BLVD SUITE 100 |
City | ROSEVILLE |
State | CA |
Zip Code | 95747-8720 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366007247 | Jasmeen Kaur Rana | Pharmacist | 1771 Pleasant Grove Blvd, Roseville, CA 95747-8720 | 2019-05-06 |
1871966341 | Maria Theresa Dimen | Pharmacist | 1771 Pleasant Grove Blvd, Roseville, CA 95747-8720 | 2015-11-05 |
1639599129 | Henry Vong Prof Dental Corp | Clinic/Center | 1771 Pleasant Grove Blvd, Ste 180, Roseville, CA 95747-8720 | 2014-04-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215407051 | Clifford Leo Faubert | Nurse Practitioner | 1937 Ellesmere Loop, Roseville, CA 95747 | 2018-12-04 |
1821577172 | Adam Botwinik | Psychologist | 8849 Cook Riolo Road, Roseville, CA 95747 | 2018-08-08 |
1093231201 | Heather Mairi Ybarra | Behavior Technician | 4216 Wyman Way, Roseville, CA 95747 | 2017-08-18 |
1881114650 | Bridget Bell | Behavior Technician | 8202 Tail Race Dr, Roseville, CA 95747 | 2017-06-22 |
1760911192 | Laura Marie Hummel | Massage Therapist | 9077 Foothills Blvd. Suite 200, Roseville, CA 95747 | 2017-06-08 |
1184975625 | Whitney Anne Wright | Marriage & Family Therapist | 7517 Locomotive Ln, Roseville, CA 95747 | 2012-09-24 |
1962764290 | Panumas Soukaroon | Physical Medicine & Rehabilitation | Glenwood Springs Way, Roseville, CA 95747 | 2012-06-12 |
1134487366 | Tatyana Serikov | Dental Hygienist | 616 Treviso Ct, Roseville, CA 95747 | 2012-04-25 |
1720352099 | Peggy Holcomb | Clinical Neuropsychologist | 4010 Foothills Bvld., Ste. 103-3, Roseville, CA 95747 | 2012-03-02 |
1740577220 | Laina Marie Haider | Occupational Therapist | 7950 Footthills Blvd, The Bridges At Woodcreek Oaks, Roseville, CA 95747 | 2011-07-05 |
Find all providers in zip 95747 |
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 |
---|---|---|---|---|
1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
1568735991 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Bldg 1, Roseville, CA 95661-3027 | 2012-02-15 |
1164659355 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Bldg 2, Roseville, CA 95661-3027 | 2009-06-16 |
1225103807 | Priceless Drug Store | Pharmacy | 446 Roseville Sq, Roseville, CA 95678-2808 | 2006-11-21 |
1992815591 | Costco Wholesale Corporation | Pharmacy | 6750 Stanford Ranch Rd, Roseville, CA 95678 | 2006-08-30 |
1720003387 | Bormans Inc | Pharmacy | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2006-07-13 |
1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
1417990284 | Longs Drug Stores California Inc | Pharmacy | 900 Sunrise Ave, Roseville, CA 95661-4507 | 2006-06-13 |
1215974647 | Lucky Stores II LLC | Pharmacy | 5060 Foothills Blvd, Roseville, CA 95747-6500 | 2006-06-02 |
1295341162 | Central Rx LLC | Pharmacy | 20733 E 13 Mile Rd, Roseville, MI 48066-4503 | 2020-09-16 |
Find all providers in ROSEVILLE |
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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.