Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
FQHC638024F UNITED INDIAN HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

UNITED INDIAN HEALTH SERVICES, INC.

Subdivision Name

Eureka Lucas St

Type

Tribal Contract/Compact with IHS (P.L. 93-638)

340B ID

FQHC638024F

Entity Address

2505 Lucas St.
Suite A
Eureka, CA 95501

Grant Number

Participating Start Date

7/1/2020

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY #10478
657 US HIGHWAY 101 N.
CRESCENT CITY, CA 95531

Pharmacy Comments

Contract Details

Approval Date

7/14/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jedediah Rudd, Chief Operating Officer
(707) 825-4049

Contract Pharmacy Representative

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

Signed By Date

7/14/2021

340B Drug Pricing Program Database