Longs Drug Stores California LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LONGS DRUG STORES CALIFORNIA LLC

Doing business as

CVS Pharmacy #09184

Practice address

3972 Missouri Flat Rd
Ste a
Placerville, CA 95667-5238

Phone

(530) 626-8642

NPI assigned

Jun 13, 2006

Last updated

Jul 8, 2026By 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 names 1

• CVS Pharmacy #09184 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member of 1

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

• CVS Pharmacy Inc

  dba CVS Pharmacy # 05874

  • Pharmacy
  • Boston, MA
  • NPI 1821197120

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Si Nae Kim

  • Pharmacist
  • Placerville, CA
  • NPI 1669220331
  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": "1783468800000",
    "number": "1205879053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "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": "3972 MISSOURI FLAT RD",
            "address_2": "STE A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675238",
            "telephone_number": "530-626-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "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": "PHY49535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #09184",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robin L Locke, M.D.
• Kristine Lynne Loken-Kuebli, AMFT
• Charae London-Lindsey, LCSW
• Alexis F Long, MD
• Marissa Danea Long, MSW
• Kaelan Vincent Lopez, SUDRC
• Rene Loranca
• Jill Denise Lovejoy-Jackson, PTA, ATC
• Katherine Luckscheider
• Jacob Dylan Luke, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.