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.
CHC28370-05 Tri-State Community Healthcare Center
Print
Covered Entity Details
Entity Name
Tri-State Community Healthcare Center
Subdivision Name
Tri-State Community Healthcare Center- Los Angeles
Type
HRSA-Funded Health Center
340B ID
CHC28370-05
Entity Address
4137 Verdugo Rd
Los Angeles, CA 90065-3820
Grant Number
H80CS28370
Participating Start Date
4/1/2020
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06976
4414 YORK BLVD
LOS ANGELES, CA 90041
Pharmacy Comments
Contract Details
Approval Date
4/9/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/27/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Aram Manoukian, CEO
(760) 326-0222 Ext: 8186584000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2020
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