LONGS DRUG STORES CALIFORNIA LLC (NPI# 1235172024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235172024 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA LLC |
| Other Organization Name | CVS PHARMACY #09371 |
| Practice Address |
300 Travis Blvd Fairfield CA 94533-3804 |
| Mailing Address |
One Cvs Drive Box 1075 Woonsocket RI 02895 |
| Practice Telephone | 7074223460 |
| Practice Fax Number | 7074223551 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2014-12-11 |
| 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 |
PHY49310 | CA | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0504781 | 01 | |
| CA | 1235172024 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #09371 | 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 |
300 TRAVIS BLVD |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-3804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437784436 | Etwina Sharon Pau | Pharmacy Technician | 300 Travis Blvd, Fairfield, CA 94533-3804 | 2020-03-10 |
| 1437617065 | Bhakti Umesh Naik | Pharmacist | 300 Travis Blvd, Fairfield, CA 94533-3804 | 2019-03-02 |
| 1437616661 | Ronald Susa | Pharmacist | 300 Travis Blvd, Fairfield, CA 94533-3804 | 2019-02-24 |
| 1811361504 | Richard Hong | Pharmacist | 300 Travis Blvd, Fairfield, CA 94533-3804 | 2015-11-18 |
| 1124408513 | Allen Dai | Pharmacist | 300 Travis Blvd, Fairfield, CA 94533-3804 | 2015-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| 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 |
|---|---|---|---|---|
| 1922440460 | Nudak Ventures LLC | Pharmacy | 2000d S Main St, Fairfield, IA 52556-9572 | 2013-07-25 |
| 1003916453 | Brookshire Brothers Inc | Pharmacy | 300 West Hwy 84, Fairfield, TX 75840 | 2006-09-25 |
| 1932203510 | Lupes Drug Store Inc | Pharmacy | 2035 Black Rock Tpke, Fairfield, CT 06825-3550 | 2006-09-12 |
| 1376645499 | Hometown Pharmacy | Pharmacy | 201 E Commerce St, Fairfield, TX 75840-1509 | 2006-09-01 |
| 1073623625 | Costco Wholesale Corporation | Pharmacy | 5101 Business Center Dr, Fairfield, CA 94534 | 2006-08-30 |
| 1598776155 | Rem Corporation | Pharmacy | 765 Nilles Rd, Suite A, Fairfield, OH 45014-9302 | 2006-08-10 |
| 1093732372 | Wal-mart Stores East Lp | Pharmacy | 7201 Aaron Aronov Dr, Fairfield, AL 35064-1831 | 2006-07-16 |
| 1841222718 | Stop and Shop Supermarket Co LLC | Pharmacy | 1160 Kings Highway Cutoff, Fairfield, CT 06824-5271 | 2006-07-07 |
| 1295703403 | American Infusion Midatlantic Inc | Pharmacy | 353 Us Highway 46 # C, Fairfield, NJ 07004-2437 | 2006-03-14 |
| 1427661404 | Walgreens | Pharmacy | 2590 N Texas St, Fairfield, CA 94533-1606 | 2020-08-28 |
| Find all providers in FAIRFIELD | ||||
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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.