Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH090390 CLINICA SIERRA VISTA

Covered Entity Details

Entity Name

CLINICA SIERRA VISTA

Subdivision Name

CORPORATE HQ - CLINICA SIERRA VISTA

Type

HRSA-Funded Health Center

340B ID

CH090390

Entity Address

1430 Truxtun Ave STE 400
Bakersfield, CA 93301

Grant Number

H80CS00540

Participating Start Date

1/1/2004

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09900
2690 MOUNT VERNON AVE
BAKERSFIELD, CA 93306

Pharmacy Comments

Contract Details

Approval Date

4/8/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Brian Harris, CEO
(661) 635-3050 Ext: 2152

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/8/2019

340B Drug Pricing Program Database