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GARFIELD BEACH CVS, L.L.C.
FQHC638012 NORTHERN VALLEY INDIAN HEALTH
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Covered Entity Details
Entity Name
NORTHERN VALLEY INDIAN HEALTH
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638012
Entity Address
207 N BUTTE STREET
WILLOWS, CA 95988
Grant Number
Participating Start Date
1/1/1995
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17468
2185 BRONZE STAR DR
WOODLAND, CA 95776
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
INDER WADHWA, CHIEF EXECUTIVE OFFICER
(530) 896-9409
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/6/2020
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