| NPI | 1003013939 |
|---|---|
| Doing Business As | LONGS DRUG STORE #164 |
| Entity Type | Organization |
| Authorized Contact | AMY M HALLIDAY Managed Care Administrator 925-210-6659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: HI 562050) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |