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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH090540 WEST OAKLAND HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
WEST OAKLAND HEALTH COUNCIL, INC.
Subdivision Name
WEST OAKLAND HEALTH CENTER..
Type
HRSA-Funded Health Center
340B ID
CH090540
Entity Address
700 Adeline St
Oakland, CA 94607-2608
Grant Number
H80CS00347
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09255
931 MARINA VILLAGE PKWY
ALAMEDA, CA 94501
Pharmacy Comments
Contract Details
Approval Date
4/2/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Preston DuFauchard, Chief Executive Officer
(510) 835-9610
Contract Pharmacy Representative
West Oakland Health Council
James McCabe, Director of Pharmacy
(510) 835-9610 Ext: 2076
Signed By Date
4/2/2021
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