Organization
LONGS DRUG STORES CALIFORNIA INC
Active
Other names
Longs Drug Store #735/Network Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY M HALLIDAY (MANAGED CARE ADMINISTRATOR)
(925) 210-6659
Entity
Organization
Contact information
Practice address
760 WASHBURN AVE, #2, CORONA, CA 92882-3303
(951) 738-1669
(951) 738-1779
Mailing address
FILE 73241, P.O. BOX 60000, SAN FRANCISCO, CA 94160-0001
(925) 210-6659
(925) 210-6606
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47568
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622332
NCPDP
CA
05
—
PHA475680
—
CA
Enumeration date
07/14/2006
Last updated
03/14/2008
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