LONGS DRUG STORES CALIFORNIA LLC (NPI# 1053354225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053354225 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA LLC |
| Other Organization Name | CVS PHARMACY #09153 |
| Practice Address |
42520 Bob Hope Dr Rancho Mirage CA 92270-4471 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7605685651 |
| Practice Fax Number | 7603419180 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-04-29 |
| 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 |
PHY49418 | CA | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0570007 | 01 | |
| CA | 1053354225 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #09153 | 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 |
42520 BOB HOPE DR |
| City | RANCHO MIRAGE |
| State | CA |
| Zip Code | 92270-4471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346849239 | Tatiana Jenistova | Pharmacist | 42520 Bob Hope Dr, Rancho Mirage, CA 92270-4471 | 2020-10-21 |
| 1124645122 | Han Na Kim | Pharmacist | 42520 Bob Hope Dr, Rancho Mirage, CA 92270-4471 | 2020-06-25 |
| 1093206351 | Julie Song | Pharmacist | 42520 Bob Hope Dr, Rancho Mirage, CA 92270-4471 | 2018-05-22 |
| 1861843112 | Matthew Groves | Pharmacist | 42520 Bob Hope Dr, Rancho Mirage, CA 92270-4471 | 2016-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235757824 | Monsetrrat Martinez | Behavioral Analyst | 69930 Ca-111, Ste 118, Rancho Mirage, CA 92270 | 2020-07-09 |
| 1306475785 | Christine Palmares | Student in an Organized Health Care Education/Training Program | 39000 Bob Hope Drive, Achs-gme Office, Rancho Mirage, CA 92270 | 2020-04-07 |
| 1821627449 | Dino Mellone | Student in an Organized Health Care Education/Training Program | 39000 Bob Hope Drive, Achs-gme Office Ste. 201, Rancho Mirage, CA 92270 | 2020-04-06 |
| 1356970164 | Chris Kim | Student in an Organized Health Care Education/Training Program | Eisenhower Health Emergency Medicine Residency, 39000 Bob Hope Dr., Achs-gme Office, Rancho Mirage, CA 92270 | 2020-04-03 |
| 1609434075 | Junko Ohara | Student in an Organized Health Care Education/Training Program | Eisenhower Health Internal Medicine Residency, 39000 Bob Hope Drive, Achs-gme Office, Rancho Mirage, CA 92270 | 2019-05-31 |
| 1245791896 | Iman Rasheed | Student in an Organized Health Care Education/Training Program | 3900 Bob Hope Drive, Achs-gme Office, Rancho Mirage, CA 92270 | 2019-03-27 |
| 1073086583 | Robert B Greene | Internal Medicine | 8 Moon Lake Drive, Rancho Mirage, CA 92270 | 2019-01-08 |
| 1356818884 | Kade Bartschi | Dentist | 1591 Griffin Rd, 29 Palms, CA 92270 | 2018-11-02 |
| 1841775392 | Rose Pharmacy Rm LLC | Pharmacy | 35400 Bob Hope Drive, Suite #207, Rancho Mirage, CA 92270 | 2018-10-01 |
| 1235615956 | Trang Huyen Nguyen | Dentist | 71-817 Hwy 111 Suite A, Rancho Mirage, CA 92270 | 2018-07-16 |
| Find all providers in zip 92270 | ||||
| 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 |
|---|---|---|---|---|
| 1699811190 | Eisenhower Medical Center | Pharmacy | 39000 Bob Hope Dr, Kiewit Bldg, Rancho Mirage, CA 92270-3221 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
| City | RANCHO MIRAGE |
| Zip Code | 92270 |
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| 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.