Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
STD941031 San Francisco AIDS Foundation

Covered Entity Details

Entity Name

San Francisco AIDS Foundation

Subdivision Name

1035 Satellite Clinic

Type

Sexually Transmitted Diseases

340B ID

STD941031

Entity Address

1035 Market Street, Suite 400
San Francisco, CA 94103

Grant Number

6NH25PS005141

Participating Start Date

4/1/2015

Last Recertification Date

5/10/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09810
1685 TULLY RD
SAN JOSE, CA 95122

Pharmacy Comments

Contract Details

Approval Date

7/13/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/29/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Chris Damon, Controller
(415) 487-3043

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