NPIMap

Organization Active NPI

Longs Drug Stores California Inc

Doing business as Longs Drug Store

  • Community/Retail Pharmacy
  • San Pablo, CA
National Provider Identifier
1912940750
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LONGS DRUG STORES CALIFORNIA INC
Doing business as
Longs Drug Store
Practice address
2455 San Pablo Dam Rd
San Pablo, CA 94806-3911
Phone
(510) 235-0810
Fax
(510) 235-0196
NPI assigned
Jun 13, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy Halliday
Title
Managed Care Administrator
Phone
(925) 210-6659

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY 44422 CA
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

2455 San Pablo Dam Rd
San Pablo, CA 94806-3911

Mailing address

141 N Civic Dr
Walnut Creek, CA 94596-3815

Other identifiers 3

IdentifierTypeStateIssuer
PHA 444220MedicaidCA
0524872OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PHA444220MedicaidCA

Other names 1

  • LONGS DRUG STORE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Longs Drug Store 61275 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2455 San Pablo Dam Rd
San Pablo, CA 94806
Phone (510) 235-0810

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1912940750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N CIVIC DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 SAN PABLO DAM RD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063911",
            "telephone_number": "510-235-0810",
            "fax_number": "510-235-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HALLIDAY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MANAGED CARE ADMINISTRATOR",
        "authorized_official_telephone_number": "925-210-6659"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY 44422",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA 444220",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0524872",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA444220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LONGS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.