Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS PHARMACY #09600
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
35720 FREMONT BLVD, FREMONT, CA 94536-3421
(510) 792-5100
(510) 792-2482
Mailing address
PO BOX 1075, BOX 1075, WOONSOCKET, RI 02895-0803
(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
PHY49315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0504743
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1609818426
—
CA
Enumeration date
06/13/2006
Last updated
10/15/2010
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