Organization
LONGS DRUG STORES CALIFORNIA INC
Active
Other names
LONGS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HALLIDAY (MANAGED CARE ADMINISTRATOR)
(925) 210-6659
Entity
Organization
Contact information
Practice address
19750 STEVENS CREEK BLVD, CUPERTINO, CA 95014-2456
(408) 255-4780
(408) 865-1228
Mailing address
141 N CIVIC DR, WALNUT CREEK, CA 94596-3815
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY 19821
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565993
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA 198210
—
CA
05
—
PHA198210
—
CA
Enumeration date
06/13/2006
Last updated
09/11/2025
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