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LONGS DRUG STORES CALIFORNIA LLC NPI 1649212457


NPI Information

NPI: 1649212457
Provider Name: LONGS DRUG STORES CALIFORNIA LLC

Doing Business As: CVS PHARMACY #09948

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 05D2223476

Address:
2700 YULUPA AVE
SANTA ROSA, CA
ZIP 95405
Phone: (707) 545-7500
Get Directions

LONGS DRUG STORES CALIFORNIA LLC is a pharmacy in Santa Rosa, 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 1649212457. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #09948.

The provider's business location address is:

2700 YULUPA AVE
SANTA ROSA, CA
ZIP 95405-577
Phone: (707) 545-7500
Fax: (707) 545-4985

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 05D2223476 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 8/23/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyPHY49660CALIFORNIANo
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
11649212457MEDICAIDCALIFORNIA
20577506OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3DL721FMEDICARE PIN
40475950150MEDICARE 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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.