Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
LONGS DRUG STORE #09968
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MANAGED CARE ADMINISTRATOR)
(401) 770-2937
Entity
Organization
Contact information
Practice address
515 N STEPHANIE ST, HENDERSON, NV 89014-6613
(702) 450-1882
(702) 450-3246
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH01185
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2802680
—
NV
01
—
2906406
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/14/2006
Last updated
12/15/2008
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