Organization
LONGS DRUG STORES CALIFORNIA INC
Active
Organization
LONGS DRUG STORES CALIFORNIA INC
Active
Other names
LONGS DRUG STORE NETWORK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HALLIDAY (MANAGED CARE ADMINISTRATOR)
(925) 210-6659
Entity
Organization
Contact information
Practice address
12276 HESPERIA RD, VICTORVILLE, CA 92395-5838
(760) 962-8007
(760) 962-8011
Mailing address
141 N CIVIC DR, WALNUT CREEK, CA 94596-3815
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY47581
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622180
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA475810
—
CA
Enumeration date
10/13/2006
Last updated
08/22/2020
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