Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS PHARMACY #09592
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1435 E GRAND AVE, ARROYO GRANDE, CA 93420-2423
(805) 474-5720
(805) 474-5725
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
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY49705
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346282175
—
CA
01
—
5602289
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/13/2006
Last updated
06/15/2012
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