Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
DSH050396 SANTA BARBARA COTTAGE HOSPITAL

Covered Entity Details

Entity Name

SANTA BARBARA COTTAGE HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050396

Entity Address

400 WEST PUEBLO STREET
SANTA BARBARA, CA 93105

Medicare Provider Number

050396

Participating Start Date

4/1/2017

Last Recertification Date

8/29/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09236
50 N ASHWOOD AVE
VENTURA, CA 93003

Pharmacy Comments

01/27/2012 changed CP name (was LONGS DRUGS #236)

Contract Details

Approval Date

1/15/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Brett Tande, Senior Vice President of Finance
(805) 569-7294

Contract Pharmacy Representative

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

Signed By Date

1/15/2021

340B Drug Pricing Program Database