Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09199
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR/PAYER RELATIIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
5420 DEWEY DR, FAIR OAKS, CA 95628
(916) 864-4803
(916) 864-4807
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49527
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871637579
—
CA
01
—
5625047
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/16/2007
Last updated
08/23/2011
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