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LONGS DRUG STORES CALIFORNIA LLC NPI 1154511491


NPI Information

NPI: 1154511491
Provider Name: LONGS DRUG STORES CALIFORNIA, LLC

Doing Business As: CVS PHARMACY #04283

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 05D2294557

Address:
3171 BALFOUR RD
BRENTWOOD, CA
ZIP 94513
Phone: (925) 626-3963
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LONGS DRUG STORES CALIFORNIA, LLC is a pharmacy in Brentwood, 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 1154511491. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #04283.

The provider's business location address is:

3171 BALFOUR RD
BRENTWOOD, CA
ZIP 94513-962
Phone: (925) 626-3963
Fax: (925) 240-9141

The provider's authorized official is Susan F Colbert .
The authorized official title is Director, Payer Relations and has the following contact phone number (401) 770-5822.

The CLIA number assigned to this NPI record is 05D2294557 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/1/2007 and was last updated on 10/13/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyPHY49521CALIFORNIANo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DL721FMEDICARE PIN
21154511491MEDICAIDCALIFORNIA
30475950615MEDICARE NSCCALIFORNIA
45627623OTHERCALIFORNIANCPDP

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: 4/28/2024

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