# LONGS DRUG STORES CALIFORNIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LONGS DRUGS \#09275
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407898232
- **Authorized official:** SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 850 KAMEHAMEHA HWY, SUITE 107, PEARL CITY, HI 96782-2682
- **Practice address phone:** (808) 455-4555
- **Practice address fax:** (808) 456-9304
- **Mailing address:** ONE CVS DRIVE, BOX 1075, WOONSOCKET, RI 02895
- **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 | PHY 719 | NULL | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 04/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08276301 | — | HI |
| 01 | — | 1200889 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |