CVS PHARMACY #11363
NPI 1174304372
Pharmacy in San Diego, CA

Active since October 12, 2023
4301 PARK BLVD, SAN DIEGO, CA 92103(401) 765-1500 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 20, 2023, Oct 19, 2023, Oct 12, 2023 (3 updates tracked since 2023).

About Cvs Pharmacy #11363 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #11363 (NPI 1174304372) is a healthcare organization registered as a pharmacy in San Diego, California and active in the NPI registry since October 2023. The organization lists Susan F Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1174304372
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameGARFIELD BEACH CVS, L.L.C.
Location Address4301 PARK BLVDSan Diego, CA 92103
Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500
Organization SubpartNo
Authorized OfficialSusan F ColbertSr. Director, Payer Relations · (401) 765-1500
Enumeration DateOctober 12, 2023
Last NPPES UpdateMarch 18, 20243 updates tracked since enumeration
NPPES CertifiedMarch 18, 2024
NPI 1174304372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
4301 PARK BLVD, San Diego, CA 92103

Other Names 1

Doing Business AsCvs Pharmacy #11363

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2057833

Vons Pharmacy 2784 · San Diego, CA
Active · expires Apr 23, 2027
CLIA Number05D2057833
Laboratory TypePharmacy
Certificate Effective DateApril 24, 2025
Certificate Expiration DateApril 23, 2027
Laboratory DirectorNashshwa Jankeel
Laboratory Phone(619) 299-0079
Laboratory LocationVons Pharmacy 2784515 W Washington St, San Diego, CA 92103
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
72 services72 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
65 services65 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
24546690
Accepts Medicare Assignment
NO
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Blood Glucose Monitors/Supplies (Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Parenteral Nutrients - Parenteral nutrient solutions
  • Parenteral Equipment and/or Supplies - Parenteral infusion pumps, parenteral nutrition supply kits
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174304372, enumerated as an "organization" on October 12, 2023.

The provider is located at 4301 PARK BLVD SAN DIEGO, CA 92103 and the phone number is (401) 765-1500.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.