Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #04151
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR/PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2050 CLUB CENTER DR, SACRAMENTO, CA 95835-1324
(916) 928-6848
(808) 982-8619
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
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY49623
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083820633
—
CA
01
—
5626948
OTHER ID NUMBER
—
Enumeration date
05/14/2007
Last updated
03/02/2012
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