# 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:** 1538103981
- **Authorized official:** AMY HALLIDAY (MANAGED CARE ADMINISTRATOR)
- **Authorized official phone:** (925) 210-6659

## Contact information

- **Practice address:** 3920 LENNANE DR, SACRAMENTO, CA 95834-1909
- **Practice address phone:** (916) 263-0233
- **Practice address fax:** (916) 928-8390
- **Mailing address:** 141 N CIVIC DR, WALNUT CREEK, CA 94596-3815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336M0002X | Mail Order Pharmacy | PHY46379 | CA | Yes |

## Other

- **Enumeration date:** 06/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0592849 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | PHA436790 | — | CA |