Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09377
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M COLBERT (DIRECTOR/PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1065 W MANNING AVE, REEDLEY, CA 93654-2446
(559) 638-0467
(559) 638-0457
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
PHY49477
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447278098
—
CA
01
—
5616187
NCPDP
CA
Enumeration date
07/18/2006
Last updated
08/23/2011
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