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LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHCLA048 County of Tulare
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Covered Entity Details
Entity Name
County of Tulare
Subdivision Name
Tulare County Health Services
Type
Health Center Program Look-Alike
340B ID
FQHCLA048
Entity Address
5957 S. Mooney Blvd
Visalia, CA 93277
Grant Number
LALCS00070
Participating Start Date
7/1/1996
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09500
1455 E NOBLE AVE
VISALIA, CA 93292
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen M Elliott, Director of Public Health
(559) 624-8481
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2020
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