Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
CVS Pharmacy #09537
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR,PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1325 W SHIELDS AVE, FRESNO, CA 93705-3341
(559) 224-6963
(559) 225-3830
Mailing address
PO BOX 1075, WOONSOCKET, RI 02895-0803
(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
PHY49691
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0504933
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1962445221
—
CA
Enumeration date
06/14/2006
Last updated
03/07/2012
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