Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09807
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
10 BAYHILL SHOPPING CTR, SAN BRUNO, CA 94066-2902
(650) 873-9522
(650) 873-9367
Mailing address
1 CVS DR, 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
PHY49354
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0524579
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1437192606
—
CA
Enumeration date
06/14/2006
Last updated
03/08/2012
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