LONGS DRUG STORES CALIFORNIA INC (NPI# 1417990284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417990284 |
| Entity Type | Organization |
| Organization Name | LONGS DRUG STORES CALIFORNIA INC |
| Other Organization Name | LONGS DRUG STORE |
| Practice Address |
900 Sunrise Ave Roseville CA 95661-4507 |
| Mailing Address |
141 N Civic Dr Walnut Creek CA 94596-3815 |
| Practice Telephone | 9167826242 |
| Practice Fax Number | 9167826858 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | AMY HALLIDAY (MANAGED CARE ADMINISTRATOR) |
| Authorized Official Telephone | 9252106659 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | PHY46255 | CA | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0588143 | 01 | |
| CA | PHA462550 | 05 | |
| CA | 6020879 | 05 |
| Other Name | Type Code |
|---|---|
| LONGS DRUG STORE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336399070 | Longs Drug Stores California Inc | Pharmacy | 2464 Wingfield Hills Rd, Sparks, NV 89436 | 2008-09-30 |
| 1447340484 | Longs Drug Stores California Inc | Pharmacy | 18182 Hwy 18 Ste 107, Apple Valley, CA 92307 | 2006-10-13 |
| 1225054000 | Longs Drug Stores California Inc | Pharmacy | 760 Washburn Ave, #2, Corona, CA 92882-3303 | 2006-07-14 |
| 1538103981 | Longs Drug Stores California Inc | Pharmacy | 3920 Lennane Dr, Sacramento, CA 95834-1909 | 2006-06-16 |
| 1356385702 | Longs Drug Stores California Inc | Pharmacy | 4158 Austin Bluffs Pkwy, Colorado Springs, CO 80918-2928 | 2006-06-16 |
| 1730122094 | Longs Drug Stores California Inc | Pharmacy | 12 N 9th Ave, Yakima, WA 98902-3065 | 2006-06-14 |
| 1649213992 | Longs Drug Stores California Inc | Pharmacy | 3540 W 10th St, Greeley, CO 80634-1824 | 2006-06-14 |
| 1376586636 | Longs Drug Stores California Inc | Pharmacy | 1209 S 320th St, Federal Way, WA 98003-5339 | 2006-06-14 |
| 1467495721 | Longs Drug Stores California Inc | Pharmacy | 15400 Ne 20th St, Bellevue, WA 98007-3834 | 2006-06-14 |
| 1265475594 | Longs Drug Stores California Inc | Pharmacy | 3670 Bel Aire Plz, Napa, CA 94558-2831 | 2006-06-14 |
| Street Address |
900 SUNRISE AVE |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-4507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942613625 | Yelena Brown | Pharmacist | 900 Sunrise Ave, Roseville, CA 95661-4507 | 2014-06-10 |
| 1205148087 | Jason P Conley | Pharmacist | 900 Sunrise Ave, Roseville, CA 95661-9566 | 2010-07-08 |
| 1306172036 | Eric Arnold | Pharmacist | 900 Sunrise Ave, Roseville, CA 95661-4507 | 2009-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| 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 |
|---|---|---|---|---|
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1568735991 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Bldg 1, Roseville, CA 95661-3027 | 2012-02-15 |
| 1164659355 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Bldg 2, Roseville, CA 95661-3027 | 2009-06-16 |
| 1225103807 | Priceless Drug Store | Pharmacy | 446 Roseville Sq, Roseville, CA 95678-2808 | 2006-11-21 |
| 1992815591 | Costco Wholesale Corporation | Pharmacy | 6750 Stanford Ranch Rd, Roseville, CA 95678 | 2006-08-30 |
| 1720003387 | Bormans Inc | Pharmacy | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2006-07-13 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1215974647 | Lucky Stores II LLC | Pharmacy | 5060 Foothills Blvd, Roseville, CA 95747-6500 | 2006-06-02 |
| 1295341162 | Central Rx LLC | Pharmacy | 20733 E 13 Mile Rd, Roseville, MI 48066-4503 | 2020-09-16 |
| 1508489303 | Fortify Market | Pharmacy | 1 Adventist Health Way, Roseville, CA 95661-3266 | 2020-05-27 |
| Find all providers in ROSEVILLE | ||||
Please comment or provide details below to improve the information on LONGS DRUG STORES CALIFORNIA INC.
| 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.