340B Drug Pricing Program Database

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09390
200 E HIGHWAY 12 STE D
VALLEY SPRINGS, CA 95252

Pharmacy Comments

Approval Date

10/15/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Jason Whitney, Finance Officer
(209) 339-7477

Contract Pharmacy Representative

Adventist Health Lodi Memorial
Sandy Beck Atwater, Pharmacy Director
(209) 339-7555

Signed By Date

10/15/2018