Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #03056
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
2293 H DELA ROSA SR ST, SOLEDAD, CA 93960-3382
(831) 678-5110
(831) 678-5110
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
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY49558
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922026517
—
CA
01
—
5616567
NCPDP
CA
Enumeration date
07/18/2006
Last updated
03/05/2012
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