Organization
LONGS DRUG STORES CALIFORNIA LLC
Active
Other names
LONGS DRUGS #03059
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
55 KIOPAA PL, MAKAWAO, HI 96768-8282
(808) 573-9304
Mailing address
1 CVS DR, PHARMACY ENROLLMENTS -BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY765
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1240302
NCPDP#
HI
05
—
628612
—
HI
Enumeration date
01/06/2009
Last updated
07/29/2021
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