Organization
LONGS DRUG STORE #366
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M CUETO (MANAGED CARE OPERATIONS MANAGER)
(925) 210-6660
Entity
Organization
Contact information
Practice address
614 PALOMAR ST, CHULA VISTA, CA 91911-7133
(619) 409-1303
(619) 409-1307
Mailing address
141 N CIVIC DR, WALNUT CREEK, CA 94596-3815
(925) 210-6660
(925) 210-6222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 48185
CA
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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