Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHCLA002E COUNTY OF MONTEREY

Covered Entity Details

Entity Name

COUNTY OF MONTEREY

Subdivision Name

Laurel Family Practice

Type

Health Center Program Look-Alike

340B ID

FQHCLA002E

Entity Address

1441 Constitution Blvd, Bldg. 400, STE 300
Salinas, CA 93906-3126

Grant Number

LALCS00049

Participating Start Date

4/1/2006

Last Recertification Date

1/31/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03050
268 RESERVATION RD
MARINA, CA 93933

Pharmacy Comments

Contract Details

Approval Date

10/8/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Julia C. Edgcomb, Clinic Services Bureau Chief/Director
(831) 796-1386

Contract Pharmacy Representative

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

Signed By Date

10/8/2019

340B Drug Pricing Program Database