Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS PHARMACY #02289
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
19701 VANOWEN ST, WINNETKA, CA 91306-3927
(818) 716-1218
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
PHY50562
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689977001
—
CA
01
—
5639642
NCPDP - OTHER COMMERCIAL IDENTIFIER
—
Enumeration date
12/07/2010
Last updated
01/26/2012
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