MEDICARE: LONGS DRUGS

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	183500000X	Pharmacist	57501	CA

General Provider Information

NPI Number	:	1275684987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGS DRUGS

Provider Business Mailing Address
First Line	:	6247 GRAHAM HILL RD
Second Line	:
City	:	FELTON
State	:	CA
Zip	:	95018-9723
Country	:	US
Telephone Number	:	831-335-6403
Fax Number	:	831-335-6407

Provider Business Practice Location Address
First Line	:	6247 GRAHAM HILL RD
Second Line	:
City	:	FELTON
State	:	CA
Zip	:	95018-9723
Country	:	US
Telephone Number	:	831-335-6403
Fax Number	:	831-335-6407

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	MS. SASHA FENIAK
Credential	:	RPH
Telephone Number	:	831-335-6403

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/22/2020

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Directions to “LONGS DRUGS ” Practice Location

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