LONGS DRUG STORES CALIFORNIA LLC (NPI# 1093757825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093757825 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA LLC |
| Other Organization Name | CVS PHARMACY #09873 |
| Practice Address |
1300 Madonna Rd San Luis Obispo CA 93405-6503 |
| Mailing Address |
1 Cvs Dr P.o. Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8055490993 |
| Practice Fax Number | 8055446353 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY49642 | CA | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 0585452 | 01 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0585452 | 01 | |
| CA | 1093757825 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #09873 | 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 |
1300 MADONNA RD |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93405-6503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558926139 | Sarah Osellame | Pharmacist | 1300 Madonna Rd, San Luis Obispo, CA 93405-6503 | 2019-05-08 |
| 1407313810 | James Parker Reid | Pharmacist | 1300 Madonna Rd, San Luis Obispo, CA 93405-6503 | 2019-02-22 |
| 1366976029 | Lin Lin | Pharmacist | 1300 Madonna Rd, San Luis Obispo, CA 93405-6503 | 2017-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076626 | Hilary Abbott Anderson | Physician Assistant | 127 Casa St., San Luis Obispo, CA 93405 | 2019-08-01 |
| 1811465834 | Fatemeh Ladan Ahmadinia | Dentist | 764 N Santa Rosa St, San Luis Obispo, CA 93405 | 2018-11-07 |
| 1538559794 | Arnold Martin Horwitz | Marriage & Family Therapist | 1605 Garnette Drive, San Luis Obispo, CA 93405 | 2015-01-27 |
| 1750794764 | Solmaz Naghsh | Pharmacist | 765 Foothill Blvd, San Luis Obispo, CA 93405 | 2014-06-06 |
| 1609293471 | Robert S. Flores Dmd, Inc | Dentist | 878 Boysen Avenue, San Luis Obispo, CA 93405 | 2014-03-18 |
| 1457776445 | Laura Anne Wilvert | Marriage & Family Therapist | 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 | 2014-02-27 |
| 1497181200 | Tracey Ruby Madrigal | Counselor | 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 | 2013-09-25 |
| 1437597572 | Sarah Michelle Brenis | Counselor | 524 Princeton Place, San Luis Obispo, CA 93405 | 2013-06-11 |
| 1013350974 | Jenna Rose Ramos | Counselor | 1459 Descanso St., San Luis Obispo, CA 93405 | 2013-04-10 |
| 1700140696 | Christopher Dieterich Marchand | Social Worker | 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 | 2012-06-26 |
| Find all providers in zip 93405 | ||||
| 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 |
|---|---|---|---|---|
| 1225582570 | Imgrx Slo Inc | Pharmacy | 77 Casa St Ste 205, San Luis Obispo, CA 93405-5803 | 2016-08-03 |
| 1023644580 | Corrections and Rehabilitation | Pharmacy | Highway 1, San Luis Obispo, CA 93409 | 2020-03-17 |
| 1356976252 | Corrections and Rehabilitation | Pharmacy | Highway 1, Bk-3, San Luis Obispo, CA 93409 | 2020-03-11 |
| 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 | SAN LUIS OBISPO |
| Zip Code | 93405 |
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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.