Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
LONGS Drugs #09988
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
91-1401 FORT WEAVER RD, EWA BEACH, HI 96706-2253
(808) 685-5621
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH604
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1203885
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
25319701
—
HI
05
—
PHA 452760
—
HI
Enumeration date
06/13/2006
Last updated
02/01/2021
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