Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
LONGS DRUGS #10153
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
54-316 KAMEHAMEHA HWY, HAUULA, HI 96717-9539
(808) 293-9091
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY-839
HI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1241102
NCPDP
—
05
—
740367
—
HI
Enumeration date
04/22/2013
Last updated
11/12/2013
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