GARFIELD BEACH CVS LLC (NPI# 1992728299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992728299 |
| Entity Type | Organization |
| Organization Name | GARFIELD BEACH CVS LLC |
| Other Organization Name | CVS PHARMACY #16294 |
| Practice Address |
2355 W Kettleman Ln Lodi CA 95242-4120 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2093390232 |
| Practice Fax Number | 2093712071 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2017-06-02 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY54008 | CA | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1992728299 | 05 | |
| PK | 2113441 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16294 | 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 |
2355 W KETTLEMAN LN |
| City | LODI |
| State | CA |
| Zip Code | 95242-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952879330 | My Huynh | Pharmacist | 2355 W Kettleman Ln, Lodi, CA 95242-4120 | 2018-11-05 |
| 1720489016 | Jonathan Anthony Tsang | Pharmacist | 2355 W Kettleman Ln, Lodi, CA 95242-4120 | 2014-09-05 |
| 1407123540 | Robert Fumio Ito | Pharmacist | 2355 W Kettleman Ln, T0853, Lodi, CA 95242-4120 | 2011-11-17 |
| 1740567098 | Sharette Sterne Haynie | Pharmacist | 2355 W Kettleman Ln, Target Pharmacy T0853, Lodi, CA 95242-4120 | 2011-11-14 |
| 1164653069 | Thomas Lenton | Pharmacist | 2355 W Kettleman Ln, Lodi, CA 95242-4120 | 2009-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
| Find all providers in zip 95242 | ||||
| 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 |
|---|---|---|---|---|
| 1831694546 | Essex Rx Care Inc | Pharmacy | 324 Essex St, Lodi, NJ 07644-2702 | 2018-03-26 |
| 1144770553 | Lodi Hometown Pharmacy LLC | Pharmacy | 801 N Main St Ste A, Lodi, WI 53555-1279 | 2016-10-10 |
| 1225327885 | Coremed Pharmacy Services | Pharmacy | 911 Industrial Way, Suite G, Lodi, CA 95240-3121 | 2011-04-05 |
| 1790823706 | Inserra Supermarkets Inc. | Pharmacy | 175 Main Street, Lodi, NJ 07644 | 2007-02-02 |
| 1003801739 | Woodbridge Pharmacy | Pharmacy | 2401 W Turner Rd, Suite 290, Lodi, CA 95242-2182 | 2005-09-19 |
| 1164453270 | K Mart Corp | Pharmacy | 520 S Cherokee Lane, Lodi, CA 95240 | 2006-07-06 |
| 1003846858 | Lodi Memorial Hospital Association Inc | Pharmacy | 2415 W Vine St, 104b, Lodi, CA 95242-3731 | 2006-07-04 |
| 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 | ||||
Please comment or provide details below to improve the information on GARFIELD BEACH CVS LLC.
| 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.