Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09843
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIANA MAURICIO (MANAGER PHARMACY ENROLLMENTS)
(401) 770-2937
Entity
Organization
Contact information
Practice address
461 W WILLIAMS AVE, FALLON, NV 89406-2734
(775) 867-3700
(775) 867-3747
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002801693
—
NV
01
—
2990477
NCPDP
NV
Enumeration date
05/10/2007
Last updated
06/03/2019
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