Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
DSH050039 ENLOE MEDICAL CENTER

Covered Entity Details

Entity Name

ENLOE MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050039

Entity Address

1531 ESPLANADE
CHICO, CA 95926

Medicare Provider Number

050039

Participating Start Date

1/1/2017

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03937
455 SOUTH MAIN STREET
RED BLUFF, CA 96080

Pharmacy Comments

Contract Details

Approval Date

7/13/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733

Contract Pharmacy Representative

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

Signed By Date

7/13/2020

340B Drug Pricing Program Database