Organization Active NPI

Longs Drug Stores California Inc

  • Community/Retail Pharmacy
  • Aloha, OR
National Provider Identifier
1124060959
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LONGS DRUG STORES CALIFORNIA INC
Doing business as
LONGS DRUG STORE
Practice address
17495 SW Farmington Rd
Aloha, OR 97007-3212
Phone
(503) 848-7700
Fax
(503) 848-7810
NPI assigned
Jun 13, 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 001451 OR
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

17495 SW Farmington Rd
Aloha, OR 97007-3212

Mailing address

141 N Civic Dr
Walnut Creek, CA 94596-3815

Other identifiers 3

IdentifierTypeStateIssuer
166704MedicaidOR
PHA459040MedicaidOR
3813119OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • LONGS DRUG STORE Doing business as

National Provider Directory

National Provider Directory

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": "1757548800000",
    "number": "1124060959",
    "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": "17495 SW FARMINGTON RD",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970073212",
            "telephone_number": "503-848-7700",
            "fax_number": "503-848-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "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": "OR",
            "license": "001451",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166704",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA459040",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3813119",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LONGS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aloha, OR

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.