Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #03025
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR,PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1385 TAVERN RD, ALPINE, CA 91901-3833
(619) 445-6903
(619) 445-6907
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821249327
—
CA
01
—
5632244
NCPDP
—
Enumeration date
10/02/2008
Last updated
01/31/2021
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