# LONGS DRUG STORES CALIFORNIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LONGS DRUGS \#09953
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174566491
- **Authorized official:** SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 45 480 KANEOHE BAY DR, KANEOHE, HI 96744
- **Practice address phone:** (808) 235-5805
- **Practice address fax:** (808) 235-6029
- **Mailing address:** 1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY534 | HI | Yes |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 02/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08257601 | — | HI |
| 01 | — | 1203330 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 6023311 | — | HI |