NPIMap

Organization Active NPI

Longs Drug Stores California Inc

  • Pharmacy
  • Washougal, WA
National Provider Identifier
1093758351
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
CF 56633 Issued in WA
Legal business name
LONGS DRUG STORES CALIFORNIA INC
Practice address
3307 Evergreen Way Ste 4
Washougal, WA 98671-2063
Phone
(360) 335-9255
Fax
(360) 335-1355
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy Halliday
Title
Managed Care Administrator
Phone
(925) 210-6659

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X CF 56633 WA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

3307 Evergreen Way Ste 4
Washougal, WA 98671-2063

Mailing address

141 N Civic Dr
Walnut Creek, CA 94596-3815

Other identifiers 3

IdentifierTypeStateIssuer
4927971OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHA462550MedicaidWA
6023451MedicaidWA

Other names 1

  • LONGS DRUG STORE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Longs Drug Store 147275 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 9

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093758351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N CIVIC DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 EVERGREEN WAY STE 4",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986712063",
            "telephone_number": "360-335-9255",
            "fax_number": "360-335-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HALLIDAY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MANAGED CARE ADMINISTRATOR",
        "authorized_official_telephone_number": "925-210-6659"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "CF 56633",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4927971",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462550",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6023451",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LONGS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washougal, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.