LONGS DRUG STORES CALIFORNIA LLC (NPI# 1063454882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063454882 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA LLC |
| Other Organization Name | CVS PHARMACY #07962 |
| Practice Address |
5685 Balboa Ave San Diego CA 92111-2705 |
| Mailing Address |
One Cvs Drive Box 1075 Woonsocket RI 02895 |
| Practice Telephone | 8582792860 |
| Practice Fax Number | 8582790424 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2011-08-23 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY49305 | CA | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0505036 | 01 | |
| CA | 1063454882 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #07962 | 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 |
5685 BALBOA AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92111-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003441080 | Jane Ye-eun Kim | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2020-03-10 |
| 1760016448 | Amy Le | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2020-03-02 |
| 1255979860 | Dasol Gloria Yoon | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2019-12-13 |
| 1497213466 | James Junsuk Lee | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2019-03-07 |
| 1881113637 | Megan Grigas | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2017-09-13 |
| 1811425465 | Stephanie Wills | Pharmacy | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2017-05-26 |
| 1295260792 | James Gonzalez | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2017-04-22 |
| 1659812543 | Jennifer Dang | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2017-03-13 |
| 1932507068 | Dawn Metrisin | Pharmacist | 5685 Balboa Ave, San Diego, CA 92111-2705 | 2014-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220653 | Karen Elizabeth Mitchell | Registered Nurse | County of San Diego California Children's Services (ccs, 6991 Balboa Ave, (room 70), San Diego, CA 92111 | 2020-06-18 |
| 1912523804 | Access Medical, Inc. | Durable Medical Equipment & Medical Supplies | 4150 Convoy Street, Suite A, San Diego, CA 92111 | 2020-06-17 |
| 1154944551 | Mei Ling Milan Szeto | Student in an Organized Health Care Education/Training Program | 7917 Ostrow Street, Suite A, San Diego, CA 92111 | 2020-05-20 |
| 1346893831 | Leticia Isabel Peralta | Assistant Behavior Analyst | 563 Balboa Avenue. Number 521, San Diego, CA 92111 | 2019-07-23 |
| 1295204394 | Demetria Serfas | Behavioral Analyst | 563 Balboa Ave #521, San Diego, CA 92111 | 2018-11-19 |
| 1568981678 | Ross Psychology | Psychologist | 4883 Ronson Court, Suite K, San Diego, CA 92111 | 2017-09-11 |
| 1225554587 | Bianca Acosta | Technician, Other | 563 Balboa Ave. #521, San Diego, CA 92111 | 2017-08-18 |
| 1194240085 | Kazuhiro Kato | Dentist | 3707 Convoy St., San Diego, CA 92111 | 2017-08-11 |
| 1073038527 | Joanne Epps-yentz | Licensed Vocational Nurse | 7414 Mesa College Dr. Apt 47, San Diego, CA 92111 | 2017-08-06 |
| 1184158446 | Positive Behavior Supports Corp | Community/Behavioral Health | 563 Balboa Ave, 521, San Diego, CA 92111 | 2017-04-13 |
| Find all providers in zip 92111 | ||||
| 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.