Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09783
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1730 SWEETWATER RD, NATIONAL CITY, CA 91950-7625
(619) 474-6703
(619) 477-0211
Mailing address
PO BOX 1075, WOONSOCKET, RI 02895-0803
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY 49347
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0551487
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1275577009
—
CA
Enumeration date
06/15/2006
Last updated
08/23/2011
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