340B Drug Pricing Program Database
LONGS DRUG STORES CALIFORNIA, L.L.C.
CH091230 LA CLINICA DE LA RAZA, INC. - information as of 5/12/2025 12:02:42 AM
Covered Entity Details
Entity Name
LA CLINICA DE LA RAZA, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH091230
Entity Address
1450 FRUITVALE AVE,
3RD FLOOR
OAKLAND, CA 94601
Grant Number
H80CS00631
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09761
2100 COLUMBUS PKWY
BENICIA, CA 94510
Pharmacy Comments
Contract Details
Approval Date
4/10/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jane Garcia, CEO
(510) 535-4000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/10/2025
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