Organization
LONGS DRUG STORE #185
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY M HALLIDAY (MANAGED CARE ADMINISTRATOR)
(925) 210-6659
Entity
Organization
Contact information
Practice address
377 KEAHOLE ST, HONOLULU, HI 96825-3405
(808) 395-4427
(808) 396-6400
Mailing address
141 N CIVIC DR, WALNUT CREEK, CA 94596-3815
(925) 210-6659
(925) 210-6606
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
562050
HI
Other
Enumeration date
07/03/2007
Last updated
08/22/2020
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