340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONGS DRUG STORES CALIFORNIA, L.L.C.
CH099010 BORREGO COMMUNITY HEALTH FOUNDATION
Print
Covered Entity Details
Entity Name
BORREGO COMMUNITY HEALTH FOUNDATION
Subdivision Name
BORREGO COMMUNITY HEALTH FOUNDATION
Type
HRSA-Funded Health Center
340B ID
CH099010
Entity Address
4343 YAQUI PASS ROAD
BORREGO SPRINGS, CA 92004-2369
Grant Number
H80CS00287
Participating Start Date
1/1/2003
Last Recertification Date
2/13/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09282
1471 W COVELL BLVD
DAVIS, CA 95616
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Mikia Wallis, Chief Executive Officer
(760) 767-6641
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session