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	PHY49369	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0504096	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1982646709
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	:	3420 CAMINO TASSAJARA
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94506-4680
Country	:	US
Telephone Number	:	925-736-0262
Fax Number	:	925-736-2123

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	:	10/15/2010

Similar Medicare Providers

1598794562 — SAFEWAY INC
Practice Location Address:

3496 CAMINO TASSAJARA
DANVILLE, CA
94506-4680

Practice Phone: 925-736-0346
Practice Fax: 925-736-0327

1699878595 — DR. DON A. HARIOKA DDS
Practice Location Address:

3476 CAMINO TASSAJARA
DANVILLE, CA
94506-4680

Practice Phone: 925-736-0190
Practice Fax:

1518029693 — DR. PETER S. VISENDI O.D.
Practice Location Address:

3464 CAMINO TASSAJARA
DANVILLE, CA
94506-4680

Practice Phone: 925-736-4911
Practice Fax:

1710151790 — DANVILLE OPTOMETRIC GROUP, INC.
Practice Location Address:

3464 CAMINO TASSAJARA
DANVILLE, CA
94506-4680

Practice Phone: 925-736-4911
Practice Fax: 925-736-8272

1346540820 — DAVID R FLOWER RPH
Practice Location Address:

3496 CAMINO TASSAJARA
DANVILLE, CA
94506-4680

Practice Phone: 925-736-0346
Practice Fax: 925-736-0327

1568763571 — MS. SHARON ERIKA YANG PHARMD
Practice Location Address:

3496 CAMINO TASSAJARA
DANVILLE, CA
94506-4680

Practice Phone: 925-736-0346
Practice Fax: 925-736-0327

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 © 2007-2026 (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.