Longs Drug Stores California LLC
Organization Active NPI Pharmacy · Sun Valley, NV
NPI 1548472012 · NPPES record last updated Jun 4, 2019
Key facts
- NPI
- 1548472012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- LONGS DRUG STORES CALIFORNIA LLC
- Practice address
- 5485 Sun Valley Blvd
Sun Valley, NV 89433-7633 - Phone
- (775) 674-1544
- Fax
- (775) 674-6146
- NPI assigned
- May 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Other NPIs on the same Medicare enrollment 14
Corporate family (same tax ID) 17
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| CVS Pharmacy #09838 |
Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090115000019 | NV | Part B Supplier - Mass Immunization (Roster Biller Only) | 1254226012 |
16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fallon, NV; Sun Valley, NV; Sparks, NV; Reno, NV; Las Vegas, NV; Henderson, NV; Carson City, NV |
| O20100930054138 | NV | DME Supplier - Pharmacy | 1254226012 | Practice locations: Sun Valley, NV |
National Provider Directory
- Tax ID family
- Longs Drug Store 147
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X | PH01335 | NV |
Addresses
Primary practice location
5485 Sun Valley Blvd
Sun Valley, NV 89433-7633
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2990427 | Other | OTHER ID NUMBER | |
| 002816040 | Medicaid | NV |
Other names
- CVS Pharmacy #09838
Other providers in Sun Valley, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.