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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH090560 UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
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Covered Entity Details
Entity Name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Subdivision Name
UNITED HEALTH CENTERS PARLIER
Type
HRSA-Funded Health Center
340B ID
CH090560
Entity Address
650 S Zediker Ave
Parlier, CA 93648-2639
Grant Number
H80CS00137
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2021
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09159
1109 COUNTRY CLUB DR
MADERA, CA 93638
Pharmacy Comments
Contract Details
Approval Date
4/3/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
COLLEEN CURTIS, CEO
(559) 646-6618 Ext: 0007
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/3/2020
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