Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09963
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5644 MISSION CENTER RD, STE 201, SAN DIEGO, CA 92108-4328
(619) 298-3655
(619) 298-6050
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
PHY49456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0548872
OTHER ID NUMBER
—
05
—
1457395287
—
CA
Enumeration date
06/15/2006
Last updated
12/19/2014
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