Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
DSH050334 SALINAS VALLEY HEALTH MEDICAL CENTER

Covered Entity Details

Entity Name

SALINAS VALLEY HEALTH MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050334

Entity Address

450 EAST ROMIE LANE
SALINAS, CA 93901

Medicare Provider Number

050334

Participating Start Date

10/1/2009

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09597
1750 41ST AVE
CAPITOLA, CA 95010

Pharmacy Comments

Contract Details

Approval Date

10/15/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Pete Delgado, CEO
(831) 755-0741

Contract Pharmacy Representative

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

Signed By Date

10/15/2019

340B Drug Pricing Program Database