Organization
LONGS DRUG STORE #733/NETWORK PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M CUETO (MANAGED CARE OPERATIONS MANAGER)
(925) 210-6660
Entity
Organization
Contact information
Practice address
12276 HESPERIA RD, VICTORVILLE, CA 92392
(760) 962-8007
(760) 962-8011
Mailing address
141 N CIVIC DR, WALNUT CREEK, CA 94596-3815
(925) 210-6660
(925) 210-6222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47581
CA
Other
Enumeration date
08/05/2006
Last updated
08/22/2020
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