Longs Drug Stores California LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LONGS DRUG STORES CALIFORNIA LLC

Practice address

63 Lincoln Blvd
Lincoln, CA 95648-9389

Phone

(916) 408-0230

Fax

(916) 408-0248

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 3

Other names 1

• CVS PHARMACY #09535 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

Practitioners 5

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

• Rafal Ammar Alsabbagh

  • Pharmacist
  • Lincoln, CA
  • NPI 1114641487
  NPD (past)
• Colin Christopher Dewald, PHARMD

  • Pharmacist
  • Lincoln, CA
  • NPI 1154850782
  NPD (past)
• Reashelle Magpayo

  • Pharmacist
  • Lincoln, CA
  • NPI 1871340216
  NPD (past)
• Lara Obeid

  • Pharmacist
  • Lincoln, CA
  • NPI 1316310246
  NPD (past)
• Anthony Petraki

  • Pharmacist
  • Lincoln, CA
  • NPI 1760206478
  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": "1418342400000",
    "number": "1447293279",
    "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": "63 LINCOLN BLVD",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956489389",
            "telephone_number": "916-408-0230",
            "fax_number": "916-408-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-12-12",
        "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": "PHY49760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0561111",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447293279",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RR PIN",
            "identifier": "P00959574",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #09535",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lincoln Physical and Occupational Therapy, Inc
• Lincoln Residences
• Lincoln Smiles
• Linconln Family Practice Associates
• Joshua Longo
• Kathryn Scott Lopez
• Nicolas Sean Losenicky
• Lumina Behavioral Services, LLC
• Raquel Karina Luna, ACSW
• Ryan Michael Lund, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.