Longs Drug Stores California LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LONGS DRUG STORES CALIFORNIA LLC

Practice address

1193 Admiral Callaghan LN
Vallejo, CA 94591-3701

Phone

(707) 552-0496

Fax

(707) 552-0382

NPI assigned

Jun 13, 2006

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

• CVS Pharmacy #09927 Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christina Crowley

  • Pharmacist
  • Vallejo, CA
  • NPI 1013381607
  NPD (past)
• Naran Arjan Kerai, RPH

  • Pharmacist
  • Vallejo, CA
  • NPI 1053848697
  NPD (past)
• Leigh Ann Stevens

  • Pharmacist
  • Vallejo, CA
  • NPI 1215464664
  NPD (past)
• Jasmine Stompanato, PHARMD

  • Pharmacist
  • Vallejo, CA
  • NPI 1043933153
  NPD (past)
• Stephanie Nicole Gofourth, PHARMD

  • Pharmacist
  • Jacksonville, FL
  • NPI 1710350293
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1154364982",
    "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": "1193 ADMIRAL CALLAGHAN LN",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945913701",
            "telephone_number": "707-552-0496",
            "fax_number": "707-552-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-05-19",
        "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": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0568393",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154364982",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #09927",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Rebecca Loeffler-Siu, M.D.
• Emerald Lofton
• Lawana Lofton, PSYD
• Shay Teresa Loftus, PH.D.
• Jake Loitz
• Dustin Michael Lopes, DO
• Ingrid Charlotte Lopes, D.O.
• Shawne Jabonero Lopes, LAC
• Abraham Lopez Chavez, PA
• Imani Lopez Duff

• Pharmacy in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.