340B Drug Pricing Program Database
GARFIELD BEACH CVS, L.L.C.
DSH050348 UCI MEDICAL CENTER - information as of 6/26/2025 12:58:50 AM
Covered Entity Details
Entity Name
UCI MEDICAL CENTER
Subdivision Name
UNIVERSITY OF CALIFORNIA, IRVINE
Type
Disproportionate Share Hospital
340B ID
DSH050348
Entity Address
101 THE CITY DR. S RT32
ORANGE, CA 92868
Medicare Provider Number
050348
Participating Start Date
1/1/1998
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09562
3981 IRVINE BOULEVARD
IRVINE, CA 92602
Pharmacy Comments
Contract Details
Approval Date
10/17/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Gannotta, Chief Executive Officer
(714) 456-7830
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/17/2018
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