Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09814
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
8101 GREENBACK LN, FAIR OAKS, CA 95628-2502
(916) 726-4466
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(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
PHY49505
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0551906
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1801830633
—
CA
Enumeration date
06/15/2006
Last updated
05/16/2012
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