Longs Drug Stores California LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY-752 Issued in HI

Legal business name

LONGS DRUG STORES CALIFORNIA LLC

Doing business as

Longs Drugs #07669

Practice address

4469 Waialo Rd
Eleele, HI 96705

Phone

(808) 335-0700

Fax

(808) 335-0755

NPI assigned

Jul 25, 2007

Last updated

Aug 26, 2011By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 2

Other names 1

• Longs Drugs #07669 Doing business as

Medicare fee-for-service enrollment

Enrolled in HI2 enrollments

Enrollment records 2

These 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc.

  dba CVS Pharmacy #17247

  • Pharmacy
  • North Dartmouth, MA
  • NPI 1831271071

  Member Of

  NPD member

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rochelle Ritsuko Braun, RPH

  • Pharmacist
  • Eleele, HI
  • NPI 1235780941
  NPD (past)
• Leland Ibara, PHARM.D.

  • Pharmacist
  • Eleele, HI
  • NPI 1750930772
  NPD (past)
• Emmanuel Salvador Melchor

  • Pharmacist
  • Kapa'a, HI
  • NPI 1235788241
  NPD (past)
• Judine Nishiguchi, PHARMD

  • Pharmacist
  • Eleele, HI
  • NPI 1417323825
  NPD (past)
• Monique P Walker

  • Pharmacist
  • Eleele, HI
  • NPI 1760854723
  NPD (past)
• Krystin Mahealani Yasay, PHARMD

  • Pharmacist
  • Lihue, HI
  • NPI 1831712926
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1023208253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "P.O. BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 WAIALO RD",
            "city": "ELEELE",
            "state": "HI",
            "postal_code": "96705",
            "telephone_number": "808-335-0700",
            "fax_number": "808-335-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2011-08-26",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY-752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598790 01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1240009",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Longs Drugs #07669",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leland Ibara, PHARM.D.
• Joscelynn Jarquio
• C. Mitchell Jenkins, M.D.
• Kauai Medical Clinic
• John Jay Kvale, DPT
• Maria Parreno, Psy.D., Inc
• Margaret Ann Merryman, MT
• Judine Nishiguchi, PHARMD
• Ralph a. Dupree, MD, LLC
• Samuel Mahelona Memorial Hospital (HHSC - Kauai Region Clinics The Clinic at Port Allen)

• Community/Retail Pharmacy in Eleele, HI
• Providers in Eleele, HI by specialty
• Community/Retail Pharmacy in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.