Longs Drug Stores California LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LONGS DRUG STORES CALIFORNIA LLC

Doing business as

CVS Pharmacy #00550

Practice address

1324 San Carlos Ave
San Carlos, CA 94070-2318

Phone

(650) 591-7659

Fax

(650) 591-7683

NPI assigned

Jun 14, 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 3

Other names 1

• CVS Pharmacy #00550 Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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 8

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

• Ala Abdel-Halim

  • Pharmacist
  • San Carlos, CA
  • NPI 1821524455
  NPD (past)
• Eun A Chang, PHARM.D

  • Pharmacist
  • San Carlos, CA
  • NPI 1346831443
  NPD (past)
• Noel Hoopai

  • Pharmacist
  • San Carlos, CA
  • NPI 1679031249
  NPD (past)
• Wilson Lam

  • Pharmacist
  • San Carlos, CA
  • NPI 1598133068
  NPD (past)
• Michelle Lee

  • Pharmacist
  • San Mateo, CA
  • NPI 1194299800
  NPD (past)
• Asher Lin I, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • San Carlos, CA
  • NPI 1093460040
  NPD (past)
• Danijela Sebisanovic

  • Pharmacist
  • San Carlos, CA
  • NPI 1548633225
  NPD (past)
• Fanny Ye, PHARMD

  • Pharmacist
  • Foster City, CA
  • NPI 1710656426
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1245273572",
    "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": "1324 SAN CARLOS AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702318",
            "telephone_number": "650-591-7659",
            "fax_number": "650-591-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-08-23",
        "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": "PHY49496",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0537499",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "0537499",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245273572",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #00550",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonia Y Liu, MD
• Russell Chandler Llewellyn, PH. D.
• Mattie Elizabeth Llido
• Joshua Lo, DO
• Annie Ngoc Long, N.P.
• Gregory R. Loomis, DDS
• Mariela Lopez-Garcia
• Daisy Evelyn Lopez
• Fergie Rebeca Lopez
• Lauren Nicole Lopez

• Pharmacy in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.