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GARFIELD BEACH CVS, L.L.C.
FQHC638017 SANTA YNEZ TRIBAL HEALTH CLINIC
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Covered Entity Details
Entity Name
SANTA YNEZ TRIBAL HEALTH CLINIC
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638017
Entity Address
90 VIA JUANA LANE
SANTA YNEZ, CA 93460
Grant Number
Participating Start Date
1/1/1995
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16105
223 E BETTERAVIA RD
SANTA MARIA, CA 93454
Pharmacy Comments
Contract Details
Approval Date
10/13/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ron Sisson, EXECUTIVE DIRECTOR
(805) 694-2650 Ext: 16
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2020
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