Longs Drug Stores California LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

562050 Issued in HI

Legal business name

LONGS DRUG STORES CALIFORNIA LLC

Doing business as

Longs Drug Store #09988

Practice address

91-1401 Fort Weaver Rd
Ewa Beach, HI 96706-2253

Phone

(808) 685-5622

Fax

(808) 685-5566

NPI assigned

Jul 20, 2007

Last updated

Dec 29, 2008By 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

Cristiana M Mauricio

Title

Manager Pharmacy Enrollments

Phone

(401) 770-2937

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Longs Drug Store #09988 Doing business as

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Longs Drug Stores California LLC

  dba LONGS Drugs #09988

  • Community/Retail Pharmacy
  • Ewa Beach, HI
  • NPI 1770525503

  O20100930039167

  Same enrollment

Member of 1

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

• CVS Pharmacy Inc.

  dba CVS Pharmacy #17247

  • Pharmacy
  • North Dartmouth, MA
  • NPI 1831271071

  Member Of

  NPD member

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1427258128",
    "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",
            "fax_number": "401-770-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-1401 FORT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062253",
            "telephone_number": "808-685-5622",
            "fax_number": "808-685-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "CRISTIANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER PHARMACY ENROLLMENTS",
        "authorized_official_telephone_number": "401-770-2937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "HI",
            "license": "562050",
            "primary": true
        },
        {
            "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": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25319701",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID",
            "identifier": "1203885",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Longs Drug Store #09988",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Albert Lin, M.D.
• Tai-Yuan David Lin, MD
• Camelle Kaipolani Liu
• Christine Alofagia Liu
• Donald Hamilton Lockwood
• Longs Drug Stores California LLC (LONGS Drugs #09988)
• Camika Lachae Lopez
• Magalita Lualua, MS REHAB COUNSELING
• Catherine Cruz Lubin, RN
• Krystle Lum

• Durable Medical Equipment & Medical Supplies in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Durable Medical Equipment & Medical Supplies in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.