340B Drug Pricing Program Database
LONGS DRUG STORES CALIFORNIA, L.L.C.
RWI946091 Primary Care at Home, INC. - information as of 4/25/2025 5:53:13 PM
Covered Entity Details
Entity Name
Primary Care at Home, INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI946091
Entity Address
400 - 29th Street
Suite 306
Oakland, CA 94609
Grant Number
H89HA00018
Participating Start Date
5/10/2021
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09331
600 FRONT ST
SANTA CRUZ, CA 95060
Pharmacy Comments
Contract Details
Approval Date
1/10/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anthony E. Jones, Board Chair
(510) 822-2588
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2022
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