Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS PHARMACY #09541
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
23330 EL TORO RD, LAKE FOREST, CA 92630-4807
(949) 830-4422
(949) 830-7343
Mailing address
1 CVS DR, P.O. BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49681
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563494
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1073556809
—
CA
Enumeration date
06/13/2006
Last updated
08/23/2011
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