Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS PHARMACY #03943
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5039 FOLSOM BLVD, SACRAMENTO, CA 95819-4440
(916) 739-0740
(916) 739-0775
Mailing address
1 CVS DR, P.O. BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-2937
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY49619
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0585832
OTHER ID NUMBER
—
05
—
1871535609
—
CA
Enumeration date
06/13/2006
Last updated
12/08/2014
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