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GARFIELD BEACH CVS, L.L.C.
FP92705 AIDS Services Foundation Orange County dba Radiant Health Centers
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Covered Entity Details
Entity Name
AIDS Services Foundation Orange County dba Radiant Health Centers
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP92705
Entity Address
2010 E. 1st Street
Suite 270
Santa Ana, CA 92705
Grant Number
FPHPA006324
Participating Start Date
7/1/2019
Last Recertification Date
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09486
5385 ALTON PARKWAY
IRVINE, CA 92604
Pharmacy Comments
Contract Details
Approval Date
5/31/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Guita Sharifi, CFO
(949) 809-5753
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2019
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