Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC28978-00 ASIAN AND PACIFIC ISLANDER WELLNESS CENTER, INC.

Covered Entity Details

Entity Name

ASIAN AND PACIFIC ISLANDER WELLNESS CENTER, INC.

Subdivision Name

Asian and Pacific Islander Wellness Center

Type

HRSA-Funded Health Center

340B ID

CHC28978-00

Entity Address

726 POLK ST, 4th Floor
San Francisco, CA 94109-7812

Grant Number

H80CS28978

Participating Start Date

4/1/2016

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01173
455 CENTER ST
HEALDSBURG, CA 95448

Pharmacy Comments

Contract Details

Approval Date

7/17/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lance Toma, Chief Executive Officer
(415) 292-3400 Ext: 355

Contract Pharmacy Representative

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

Signed By Date

7/17/2020

340B Drug Pricing Program Database