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Organization

LONGS DRUG STORES CALIFORNIA LLC

Active
Other names
CVS PHARMACY #09233
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN COLBERT (DIRECTOR/PAYER RELATIONS)
(401) 770-2751
Entity
Organization

Contact information

Practice address
515 S STATE HIGHWAY 49, JACKSON, CA 95642-2534
(209) 223-2471
(209) 223-1811
Mailing address
1 CVS DR, P.O. 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
PHY49510
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0588167
OTHER ID NUMBER
05
1821030644
CA
Enumeration date
06/13/2006
Last updated
03/06/2012
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