# LONGS DRUG STORES CALIFORNIA INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LONGS DRUG STORE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083657878
- **Authorized official:** AMY HALLIDAY (MANAGED CARE ADMINISTRATOR)
- **Authorized official phone:** (925) 210-6659

## Contact information

- **Practice address:** 10164 SW WASHINGTON SQUARE RD, TIGARD, OR 97223-4458
- **Practice address phone:** (503) 639-1110
- **Practice address fax:** (503) 639-9484
- **Mailing address:** 141 N CIVIC DR, WALNUT CREEK, CA 94596-3815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 001252 | OR | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 166713 | — | OR |
| 01 | — | 3813121 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |