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LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHCLA368 WAHIAWA CENTER FOR COMMUNITY HEALTH, THE
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Covered Entity Details
Entity Name
WAHIAWA CENTER FOR COMMUNITY HEALTH, THE
Subdivision Name
The Wahiawa Center for Community Health
Type
Health Center Program Look-Alike
340B ID
FQHCLA368
Entity Address
302 CALIFORNIA AVE STE 106
Wahiawa, HI 96786-1841
Grant Number
LALCS31600
Participating Start Date
7/1/2018
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: LONGS DRUGS # 03070
66-197 KAMEHAMEHA HWY., #1
HALEIWA, HI 96712
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beverly Harbin, CEO
(808) 591-0000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2018
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