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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09288C Lifelong Medical Care
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Covered Entity Details
Entity Name
Lifelong Medical Care
Subdivision Name
LMC - EAST OAKLAND CLINIC
Type
HRSA-Funded Health Center
340B ID
CH09288C
Entity Address
10700 MACARTHUR BLVD
Ste 14
OAKLAND, CA 94605-5298
Grant Number
H80CS00808
Participating Start Date
7/1/1999
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09942
1401 WASHINGTON AVE
SAN LEANDRO, CA 94577
Pharmacy Comments
Contract Details
Approval Date
4/15/2008
Contract Begin Date
4/15/2008
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/19/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
4/7/2008
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