340B Drug Pricing Program Database
LONGS DRUG STORES CALIFORNIA, L.L.C.
STD92506 Planned Parenthood of the Pacific Southwest - information as of 6/3/2025 12:46:48 PM
Covered Entity Details
Entity Name
Planned Parenthood of the Pacific Southwest
Subdivision Name
Riverside
Type
Sexually Transmitted Diseases
340B ID
STD92506
Entity Address
3772 TIBBETTS
RIVERSIDE, CA 92506
Grant Number
1H25PS005127
Participating Start Date
1/1/2016
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09538
1792 GARNET AVE
SAN DIEGO, CA 92109
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Darrah Johnson, CEO
(619) 881-5050 Ext: 6198815050
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2022
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