Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09393
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR/PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2075 MENDOCINO AVE, SANTA ROSA, CA 95401-3667
(707) 542-4182
(707) 542-8914
Mailing address
ONE CVS DRIVE, WOONSOCKET, RI 02895
(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
PHY49311
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0504793
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1699719039
—
CA
Enumeration date
06/16/2006
Last updated
08/23/2011
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