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LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC12872-00 WellSpace Health
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Covered Entity Details
Entity Name
WellSpace Health
Subdivision Name
J Street Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12872-00
Entity Address
1820 J Street
Sacramento, CA 95811-3010
Grant Number
H80CS12872
Participating Start Date
7/1/2018
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02290
1587 W EL CAMINO AVE
SACRAMENTO, CA 95833
Pharmacy Comments
Contract Details
Approval Date
10/7/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alasdair Jonathan Porteus, CEO
(916) 550-5444
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/7/2019
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