Organization
LONGS DRUG STORES CALIFORNIA INC
Active
Other names
LONGS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HALLIDAY (MANAGED CARE ADMINISTRATOR)
(925) 210-6659
Entity
Organization
Contact information
Practice address
3920 LENNANE DR, SACRAMENTO, CA 95834-1909
(916) 263-0233
(916) 928-8390
Mailing address
141 N CIVIC DR, WALNUT CREEK, CA 94596-3815
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
PHY46379
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0592849
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA436790
—
CA
Enumeration date
06/16/2006
Last updated
08/22/2020
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