Organization
LONGS DRUG STORES CALIFORNIA, LLC
Active
Other names
CVS Pharmacy #04283
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-5822
Entity
Organization
Contact information
Practice address
3171 BALFOUR RD, BRENTWOOD, CA 94513-2962
(925) 626-3963
(925) 240-9141
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
PHY49521
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154511491
—
CA
01
—
5627623
NCPDP
CA
Enumeration date
08/01/2007
Last updated
10/13/2010
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