LONGS DRUG STORES CALIFORNIA LLC (NPI# 1043253834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043253834 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA LLC |
| Other Organization Name | CVS PHARMACY #09958 |
| Practice Address |
5090 Foothills Blvd Roseville CA 95747-6517 |
| Mailing Address |
1 Cvs Dr P.o. Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 9167831355 |
| Practice Fax Number | 9167831360 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-03-08 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY49451 | CA | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 0524529 | 01 | |
| CA | 1043253834 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0524529 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #09958 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869340 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 988 Halekauwila St, Honolulu, HI 96814-4013 | 2019-09-09 |
| 1205203544 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 5156 Kalanianaole Hwy, Honolulu, HI 96821-1507 | 2015-08-21 |
| 1154707537 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 2829 Ala Kalani Kaumaka St, Ste M-167, Koloa, HI 96756-8571 | 2015-08-07 |
| 1376934026 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 275 W Kaahumanu Ave # 1c01a, Kahului, HI 96732-1629 | 2015-02-16 |
| 1295123636 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 100 Hookele St, Kahului, HI 96732 | 2015-01-08 |
| 1073959144 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 841 Bishop St, Suite 105, Honolulu, HI 96813-3908 | 2013-05-16 |
| 1831447861 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 135 Kehalani Village Dr, Wailuku, HI 96793-2197 | 2012-08-23 |
| 1992062970 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 95-1077 Ainamakua Dr, Mililani, HI 96789-4252 | 2012-04-16 |
| 1144523465 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 91-919 Ft Weaver Rd Spc 106, Ewa Beach, HI 96706 | 2010-12-08 |
| 1689977001 | Longs Drug Stores California LLC | Durable Medical Equipment & Medical Supplies | 19701 Vanowen St, Winnetka, CA 91306-3927 | 2010-12-07 |
| Street Address |
5090 FOOTHILLS BLVD |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95747-6517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770148462 | Melissa Krocheski | Pharmacist | 5090 Foothills Blvd, Roseville, CA 95747-6517 | 2019-05-08 |
| 1255996138 | Van L Khine | Pharmacist | 5090 Foothills Blvd, Roseville, CA 95747-6517 | 2019-05-06 |
| 1316411960 | Michael Alan Page | Pharmacist | 5090 Foothills Blvd, Roseville, CA 95747-6517 | 2019-01-16 |
| 1235449018 | Rasha H Abdelwahed | Pharmacist | 5090 Foothills Blvd, Roseville, CA 95747-6517 | 2010-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215407051 | Clifford Leo Faubert | Nurse Practitioner | 1937 Ellesmere Loop, Roseville, CA 95747 | 2018-12-04 |
| 1821577172 | Adam Botwinik | Psychologist | 8849 Cook Riolo Road, Roseville, CA 95747 | 2018-08-08 |
| 1093231201 | Heather Mairi Ybarra | Behavior Technician | 4216 Wyman Way, Roseville, CA 95747 | 2017-08-18 |
| 1881114650 | Bridget Bell | Behavior Technician | 8202 Tail Race Dr, Roseville, CA 95747 | 2017-06-22 |
| 1760911192 | Laura Marie Hummel | Massage Therapist | 9077 Foothills Blvd. Suite 200, Roseville, CA 95747 | 2017-06-08 |
| 1184975625 | Whitney Anne Wright | Marriage & Family Therapist | 7517 Locomotive Ln, Roseville, CA 95747 | 2012-09-24 |
| 1962764290 | Panumas Soukaroon | Physical Medicine & Rehabilitation | Glenwood Springs Way, Roseville, CA 95747 | 2012-06-12 |
| 1134487366 | Tatyana Serikov | Dental Hygienist | 616 Treviso Ct, Roseville, CA 95747 | 2012-04-25 |
| 1720352099 | Peggy Holcomb | Clinical Neuropsychologist | 4010 Foothills Bvld., Ste. 103-3, Roseville, CA 95747 | 2012-03-02 |
| 1740577220 | Laina Marie Haider | Occupational Therapist | 7950 Footthills Blvd, The Bridges At Woodcreek Oaks, Roseville, CA 95747 | 2011-07-05 |
| Find all providers in zip 95747 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1568735991 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Bldg 1, Roseville, CA 95661-3027 | 2012-02-15 |
| 1164659355 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Bldg 2, Roseville, CA 95661-3027 | 2009-06-16 |
| 1225103807 | Priceless Drug Store | Pharmacy | 446 Roseville Sq, Roseville, CA 95678-2808 | 2006-11-21 |
| 1992815591 | Costco Wholesale Corporation | Pharmacy | 6750 Stanford Ranch Rd, Roseville, CA 95678 | 2006-08-30 |
| 1720003387 | Bormans Inc | Pharmacy | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2006-07-13 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1417990284 | Longs Drug Stores California Inc | Pharmacy | 900 Sunrise Ave, Roseville, CA 95661-4507 | 2006-06-13 |
| 1215974647 | Lucky Stores II LLC | Pharmacy | 5060 Foothills Blvd, Roseville, CA 95747-6500 | 2006-06-02 |
| 1295341162 | Central Rx LLC | Pharmacy | 20733 E 13 Mile Rd, Roseville, MI 48066-4503 | 2020-09-16 |
| Find all providers in ROSEVILLE | ||||
Please comment or provide details below to improve the information on LONGS DRUG STORES CALIFORNIA LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.