340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONGS DRUG STORES CALIFORNIA, L.L.C.
DSH050360 MARIN GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
MARIN GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050360
Entity Address
250 BON AIR ROAD
GREENBRAE, CA 94904
Medicare Provider Number
050360
Participating Start Date
7/1/2016
Last Recertification Date
9/10/2024
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09370
880 SIR FRANCIS DRAKE BLVD
SAN ANSELMO, CA 94960
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
Elizabeth Lasnier, Controller
(415) 925-7449
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session