Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC08739-00 Aria Community Health Center

Covered Entity Details

Entity Name

Aria Community Health Center

Subdivision Name

AVENAL COMMUNITY HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CHC08739-00

Entity Address

1000 Skyline Blvd Ste A
Avenal, CA 93204-1850

Grant Number

H80CS08739

Participating Start Date

7/1/2009

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09129
1302 FULTON MALL
FRESNO, CA 93721

Pharmacy Comments

Contract Details

Approval Date

4/3/2020

Contract Begin Date

6/8/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/13/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

John Blaine, CEO
(559) 386-4500 Ext: 1010

Contract Pharmacy Representative

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

Signed By Date

4/3/2020

340B Drug Pricing Program Database