LONGS DRUG STORES CALIFORNIA LLC NPI 1144263930

NPI Information

  • NPI: 1144263930
  • Provider Name: LONGS DRUG STORES CALIFORNIA LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CVS PHARMACY #09752
  • CLIA Number: 05D2300782
  • Address: 375 GELLERT BLVD
    DALY CITY, CA
    ZIP 94015
  • Phone: (650) 994-0752

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NPI Details

LONGS DRUG STORES CALIFORNIA LLC is a pharmacy in Daly City, CA. The provider is 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. LONGS DRUG STORES CALIFORNIA LLC NPI is 1144263930. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #09752.

The provider's business location address is:

375 GELLERT BLVD
DALY CITY, CA
ZIP 94015-613
Phone: (650) 994-0752
Fax: (650) 994-2619

The provider's authorized official is Susan Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 05D2300782 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
  • Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free (HCPCS:90674)

The enumeration date for this NPI number is 6/13/2006 and was last updated on 8/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyPHY49708CALIFORNIANo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10504882OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2DL721FMEDICARE PIN
31144263930MEDICAIDCALIFORNIA
40475950145MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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