MEDICARE: LONGS DRUG STORES CALIFORNIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PHY49364	CA
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0597940	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083656813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGS DRUG STORES CALIFORNIA LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	P.O. BOX 1075
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:	401-770-7108

Provider Business Practice Location Address
First Line	:	581 W CHANNEL ISLANDS BLVD
Second Line	:
City	:	PORT HUENEME
State	:	CA
Zip	:	93041-2133
Country	:	US
Telephone Number	:	805-985-4479
Fax Number	:	805-985-5452

Authorized Official
Title or Position	:	DIRECTOR, PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/23/2011

Similar Medicare Providers

1073796009 — ELIZABETH BABU MD
Practice Location Address:

567 W CHANNEL ISLANDS BLVD , #159
PORT HUENEME, CA
93041-2133

Practice Phone: 516-303-6931
Practice Fax:

1093035651 — MS. PAULINE LAI PHARM.D.
Practice Location Address:

581 W CHANNEL ISLANDS BLVD
PORT HUENEME, CA
93041-2133

Practice Phone: 805-985-4479
Practice Fax: 805-985-5452

1689025561 — DR. ESTHER CHAN PHARMD
Practice Location Address:

581 W CHANNEL ISLANDS BLVD
PORT HUENEME, CA
93041-2133

Practice Phone: 805-985-4479
Practice Fax:

1215591490 — GRIGOR DEREMSEZYAN
Practice Location Address:

581 W CHANNEL ISLANDS BLVD
PORT HUENEME, CA
93041-2133

Practice Phone: 805-985-4479
Practice Fax:

1295038032 — NEW LIFE ASSISTED LIVING, INC.
Practice Location Address:

2133 SHELTER DRIVE
PORT ST. LUCIE, FL
34952

Practice Phone: 772-337-0058
Practice Fax: 772-398-4238

1265984900 — AMY E. MILLER APRN
Practice Location Address:

1019 PALM BLVD
PORT ST JOE, FL
32456-2133

Practice Phone: 850-296-0318
Practice Fax:

Directions to “LONGS DRUG STORES CALIFORNIA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.