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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09087W ALAMEDA, COUNTY OF
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Covered Entity Details
Entity Name
ALAMEDA, COUNTY OF
Subdivision Name
HAYWARD WELLNESS
Type
HRSA-Funded Health Center
340B ID
CH09087W
Entity Address
664 Southland Mall Dr
Hayward, CA 94545-1273
Grant Number
H80CS00047
Participating Start Date
4/1/2005
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09622
243 W JACKSON ST
HAYWARD, CA 94544
Pharmacy Comments
Contract Details
Approval Date
11/1/2008
Contract Begin Date
11/1/2008
Carve-In Effective Date
Contract Comments
10/26/09 CONTR PHARM NAME CHANGE (WAS LONGS DRUGS/CVS #53)
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
9/4/2008
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