Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
LONGS DRUGS #10060
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
135 KEHALANI VILLAGE DR, WAILUKU, HI 96793-2197
(808) 242-5606
Mailing address
1 CVS DR, BOX 1075 PHARMACY ENROLLMENT, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY-820
HI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1240910
NCPDP
—
05
—
733619
—
HI
Enumeration date
08/23/2012
Last updated
04/03/2013
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