LONGS DRUG STORES CALIFORNIA LLC (NPI# 1275576001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275576001 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA LLC |
| Other Organization Name | CVS PHARMACY #09538 |
| Practice Address |
1792 Garnet Ave San Diego CA 92109-3350 |
| Mailing Address |
1 Cvs Dr P.o. Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 8584831489 |
| Practice Fax Number | 8584832237 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-06-15 |
| 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 |
PHY49680 | CA | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0559279 | 01 | |
| OTHER ID NUMBER | 0559279 | 01 | |
| CA | 1275576001 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #09538 | 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 |
1792 GARNET AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92109-3350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012060 | Angela Hoefke | Nurse Practitioner | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2020-10-28 |
| 1184231326 | Cindy F Tolentino | Nurse Practitioner | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2020-09-30 |
| 1558999466 | Dario Nassif | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2020-03-28 |
| 1376176776 | Nora Elmajian | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2020-02-13 |
| 1295371300 | Son Ngoc Luu | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2019-11-24 |
| 1710521240 | Darnell Ongkingco Yumol | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2019-10-28 |
| 1972067478 | Natasha Nicole Romero | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2019-01-29 |
| 1245794296 | Christopher Shim | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2019-01-23 |
| 1548730468 | Diana Lee Telahun | Pharmacist | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2018-12-04 |
| 1043708456 | Nicole O'donnell | Nurse Practitioner | 1792 Garnet Ave, San Diego, CA 92109-3350 | 2018-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538620786 | San Diego Forensic Psychology Corporation | Psychologist | 4640 Cass Street, # 90422, San Diego, CA 92109 | 2019-03-29 |
| 1982113874 | Holly Mansur | Registered Nurse | 3663 Jewell Street, San Diego, CA 92109 | 2017-09-24 |
| 1669906178 | Kelley Ann Riley | Prevention Professional | 4328 Gresham St, San Diego, CA 92109 | 2017-04-12 |
| 1689113524 | Tyler Marquis | Pharmacist | 2636 Grand Avenue Apartment 326, San Diego, CA 92109 | 2017-02-13 |
| 1912372574 | Lonnie Butler | Doula | 841 Turquoise Street, F-405, San Diego, CA 92109 | 2015-12-08 |
| 1275924995 | Pratima S. Gowdar, Dds, Inc | Dentist | 4655 Cass St. Ste 104, San Diego, CA 92109 | 2015-02-17 |
| 1417388562 | Pacific Rim Pathology Medical Corporation | Clinical Medical Laboratory | 3030 Bunker Hill Street, Suite 201, San Diego, CA 92109 | 2013-11-27 |
| 1023379997 | Eric Berquist | Student in an Organized Health Care Education/Training Program | 2009 Reed Ave, San Diego, CA 92109 | 2012-06-06 |
| 1982996724 | Miramar Health Physicians Group | Acupuncturist | 1321 Garnet Avenue, San Diego, CA 92109 | 2011-05-12 |
| 1902109325 | Anna N Amagou | Behavioral Analyst | 2221 Felspar Street Apt #c, San Diego, CA 92109 | 2010-12-07 |
| Find all providers in zip 92109 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1720607112 | Kaiser Foundation Health Plan Inc | Pharmacy | 6911 Convoy Ct Fl 1 Rm 1501, San Diego, CA 92111-1014 | 2020-04-15 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1942772272 | Rising Star Holdings LLC | Pharmacy | 500 S Dr Ee Dunlap Hwy Ste C, San Diego, TX 78384-3415 | 2018-12-27 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| 1912362377 | Dt Pharmacy Corporation | Pharmacy | 5507 El Cajon Blvd # E, San Diego, CA 92115-3624 | 2015-12-29 |
| 1649600487 | Aids Healthcare Foundation | Pharmacy | 3940 Fourth Avenue, Suite 150, San Diego, CA 92103-7193 | 2013-11-14 |
| 1144574260 | Medpilot Pharmacy Inc. | Pharmacy | 9323 Chesapeake Dr, Suite #c1, San Diego, CA 92123-1044 | 2012-10-29 |
| Find all providers in SAN DIEGO | ||||
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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.