Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH091880 BAY CLINIC, INC.

Covered Entity Details

Entity Name

BAY CLINIC, INC.

Subdivision Name

Hilo Family Health Center

Type

HRSA-Funded Health Center

340B ID

CH091880

Entity Address

1178 Kinoole Street
Bldg. B
Hilo, HI 96720

Grant Number

H80CS00837

Participating Start Date

10/1/2004

Last Recertification Date

2/23/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

LONGS DRUGS # 17599
391 E MAKAALA ST
HILO, HI 96720

Pharmacy Comments

Contract Details

Approval Date

1/2/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Christian Kimo Alameda, Chief Executive Officer
(808) 930-4083

Contract Pharmacy Representative

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

Signed By Date

1/2/2020

340B Drug Pricing Program Database