Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC28988-00 DAP HEALTH INC

Covered Entity Details

Entity Name

DAP HEALTH INC

Subdivision Name

Desert AIDS Project, Inc.

Type

HRSA-Funded Health Center

340B ID

CHC28988-00

Entity Address

1695 N Sunrise Way
Palm Springs, CA 92262-3701

Grant Number

H80CS28988

Participating Start Date

4/1/2016

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09656
2771 4TH ST
SANTA ROSA, CA 95405

Pharmacy Comments

Contract Details

Approval Date

10/9/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

David Brinkman, Chief Executive Officer
(760) 992-0418

Contract Pharmacy Representative

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

Signed By Date

10/9/2020

340B Drug Pricing Program Database