Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09967
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1950 VILLAGE CENTER CIR, LAS VEGAS, NV 89134-6236
(702) 363-5292
(702) 363-5623
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
PH01250
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2802926
—
NV
01
—
2906595
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/15/2006
Last updated
06/04/2019
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