Active NPI
Longs Drug Stores California LLC
Doing business as CVS Pharmacy #09793
- Community/Retail Pharmacy
- Santa Clara, CA
National Provider Identifier
1003859844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY49348
- Legal business name
- LONGS DRUG STORES CALIFORNIA LLC
- Doing business as
- CVS Pharmacy #09793
- Practice address
- 2700 Homestead Rd
Santa Clara, CA 95051-5353 - Phone
- (408) 247-8700
- Fax
- (408) 247-8214
- NPI assigned
- Jun 13, 2006
- Last updated
- Aug 23, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Colbert
- Title
- Director/Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY49348 | CA | Primary |
Addresses
Primary practice location
2700 Homestead Rd
Santa Clara, CA 95051-5353
Mailing address
One CVS Drive Box 1075
Woonsocket, RI 02895-0001
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0523666 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 1003859844 | Medicaid | CA |
Other names 1
- CVS Pharmacy #09793
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930077340 | CA | DME Supplier - Pharmacy | 1254226012 | Practice locations: Santa Clara, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Longs Drug Stores California LLC | Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Longs Drug Store 172
Organizations with this tax ID in the same state 12
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Retail Pharmacy
- Victorville, CA
- NPI 1023027620
-
dba CVS Pharmacy #09935
- Community/Retail Pharmacy
- Oakhurst, CA
- NPI 1013950856
-
dba CVS Pharmacy #03057
- Community/Retail Pharmacy
- Laguna Niguel, CA
- NPI 1073555801
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1314057600000",
"number": "1003859844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE CVS DRIVE BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028950001",
"telephone_number": "401-765-1500",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 HOMESTEAD RD",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950515353",
"telephone_number": "408-247-8700",
"fax_number": "408-247-8214"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-13",
"last_updated": "2011-08-23",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "DIRECTOR/PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY49348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0523666",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003859844",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #09793",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.