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NPI Code Detail

MEDICARE: LONGS DRUG STORES CALIFORNIA LLC

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
13336C0003XCommunity/Retail PharmacyPHY49310CA
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10504781OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235172024
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONGS DRUG STORES CALIFORNIA LLC
Provider Business Mailing Address
First Line : ONE CVS DRIVE
Second Line : BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895
Country : US
Telephone Number : 401-765-1500
Fax Number : 401-770-7108
Provider Business Practice Location Address
First Line : 300 TRAVIS BLVD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-3804
Country : US
Telephone Number : 707-422-3460
Fax Number : 707-422-3551
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 : 12/11/2014

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Directions to “LONGS DRUG STORES CALIFORNIA LLC ” Practice Location

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