Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09805
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1720 S BASCOM AVE, CAMPBELL, CA 95008-0608
(408) 371-7191
(408) 371-0546
Mailing address
1 CVS DR, 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
PHY49352
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0523654
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1194768937
—
CA
Enumeration date
06/13/2006
Last updated
03/05/2012
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