340B Drug Pricing Program Database
LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09071AQ COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC. - information as of 4/28/2025 11:29:48 PM
Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Subdivision Name
COMMUNITY HEALTH CENTERS BROADWAY DENTAL
Type
HRSA-Funded Health Center
340B ID
CH09071AQ
Entity Address
210 N Broadway
Santa Maria, CA 93454-4415
Grant Number
H80CS00621
Participating Start Date
1/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09871
1317 N H ST
LOMPOC, CA 93436
Pharmacy Comments
Contract Details
Approval Date
5/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/5/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
5/4/2023
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