Active NPI
Longs Drug Stores California LLC
Doing business as CVS Pharmacy #09815
- Pharmacy
- Walnut Creek, CA
National Provider Identifier
1962446310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- LONGS DRUG STORES CALIFORNIA LLC
- Doing business as
- CVS Pharmacy #09815
- Practice address
- 738 Bancroft Rd
Walnut Creek, CA 94598-1531 - Phone
- (925) 938-8525
- Fax
- (925) 938-0646
- NPI assigned
- Jun 16, 2006
- Last updated
- Mar 8, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan F Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X | PHY49504 | CA |
Addresses
Primary practice location
738 Bancroft Rd
Walnut Creek, CA 94598-1531
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962446310 | Medicaid | CA | |
| 0552299 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS Pharmacy #09815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930061503 | CA | DME Supplier - Pharmacy | 1254226012 | Practice locations: Walnut Creek, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Longs Drug Store #09815 | 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 |
National Provider Directory
National Provider Directory- Tax ID family
- Longs Drug Store 61
Organizations with this tax ID in the same state 18
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Longs Drug Store Network Pharmacy
- Community/Retail Pharmacy
- Victorville, CA
- NPI 1912097957
-
dba Longs Drug Store
- Community/Retail Pharmacy
- San Pablo, CA
- NPI 1912940750
-
- Pharmacy
- Merced, CA
- NPI 1952344210
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331164800000",
"number": "1962446310",
"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": "738 BANCROFT RD",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945981531",
"telephone_number": "925-938-8525",
"fax_number": "925-938-0646"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGS DRUG STORES CALIFORNIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-16",
"last_updated": "2012-03-08",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "F",
"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": "PHY49504",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1962446310",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "0552299",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS Pharmacy #09815",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Walnut Creek, CA
- Michael Min Jung Long, P.T.
- Taylor Long
- Longs Drug Stores California Inc (Longs Drug Store)
- Longs Drug Stores California LLC (CVS Pharmacy #09324)
- Longs Drug Stores California LLC (CVS Pharmacy #09545)
- Longs Drug Stores California, Inc.
- William Cooper Longton, MD
- Benjamin Longwell, D.O.
- Gary Orlando Lons, MSW
- Patricia K Loo, P.A.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.