Active NPI
Longs Drug Stores California LLC
Doing business as CVS Pharmacy #09342
- Pharmacy
- Morgan Hill, CA
National Provider Identifier
1124061486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- LONGS DRUG STORES CALIFORNIA LLC
- Doing business as
- CVS Pharmacy #09342
- Practice address
- 16995 Walnut Grove Dr
Morgan Hill, CA 95037-4440 - Phone
- (408) 779-6981
- NPI assigned
- Jun 14, 2006
- Last updated
- Sep 27, 2012
- 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 | NU | ||
| Pharmacy | 333600000X | NU | Primary | |
| Community/Retail Pharmacy | 3336C0003X | PHY49393 | CA |
Addresses
Primary practice location
16995 Walnut Grove Dr
Morgan Hill, CA 95037-4440
Mailing address
1 CVS Dr
P.O. Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124061486 | Medicaid | CA | |
| 0553669 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS Pharmacy #09342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930094734 | CA | DME Supplier - Pharmacy | 1254226012 | Practice locations: Morgan Hill, 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 |
|---|---|---|
| CVS Pharmacy #09342 | 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 61
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Longs Drug Store
- Community/Retail Pharmacy
- Berkeley, CA
- NPI 1164465951
-
dba Longs Drug Store #735/Network Pharmacy
- Community/Retail Pharmacy
- Corona, CA
- NPI 1225054000
-
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": "1150243200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1348704000000",
"number": "1124061486",
"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",
"fax_number": "401-770-7108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16995 WALNUT GROVE DR",
"city": "MORGAN HILL",
"state": "CA",
"postal_code": "950374440",
"telephone_number": "408-779-6981"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-14",
"last_updated": "2012-09-27",
"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": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY49393",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124061486",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0553669",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #09342",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Morgan Hill, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.