NPIMap

Organization Active NPI

Longs Drug Stores California LLC

Doing business as CVS Pharmacy #09246

  • Pharmacy
  • Laguna Woods, CA
National Provider Identifier
1912949736
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
LONGS DRUG STORES CALIFORNIA LLC
Doing business as
CVS Pharmacy #09246
Practice address
24167 Paseo de Valencia
Laguna Woods, CA 92637-3110
Phone
(949) 586-3503
Fax
(949) 586-2111
NPI assigned
Jun 13, 2006
Last updated
Mar 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X PHY49647 CA

Addresses

Primary practice location

24167 Paseo de Valencia
Laguna Woods, CA 92637-3110

Mailing address

1 CVS Dr
P.O. Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 2

IdentifierTypeStateIssuer
1912949736MedicaidCA
0588155OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • CVS Pharmacy #09246 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100909000881 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1254226012 This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
CVS Pharmacy #0924624167 Paseo de Valencia, Laguna Woods, CA 92637-3110(949) 586-3503 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 assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1330992000000",
    "number": "1912949736",
    "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": "24167 PASEO DE VALENCIA",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373110",
            "telephone_number": "949-586-3503",
            "fax_number": "949-586-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2012-03-06",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY49647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912949736",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0588155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #09246",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laguna Woods, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.