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LONGS DRUG STORES CALIFORNIA, L.L.C.
CAH051334-00 OJAI VALLEY COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
OJAI VALLEY COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051334-00
Entity Address
1306 MARICOPA HIGHWAY
OJAI, CA 93023
Medicare Provider Number
051334
Participating Start Date
1/1/2017
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09969
7850 TELEGRAPH RD
VENTURA, CA 93004
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DAVID BURRIS GLYER, cfo
(805) 652-5003
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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