Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
CH099010 BORREGO COMMUNITY HEALTH FOUNDATION

Covered Entity Details

Entity Name

BORREGO COMMUNITY HEALTH FOUNDATION

Subdivision Name

BORREGO COMMUNITY HEALTH FOUNDATION

Type

HRSA-Funded Health Center

340B ID

CH099010

Entity Address

4343 YAQUI PASS ROAD
BORREGO SPRINGS, CA 92004-2369

Grant Number

H80CS00287

Participating Start Date

1/1/2003

Last Recertification Date

2/13/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08897
3361 MARKET ST.
RIVERSIDE, CA 92501

Pharmacy Comments

Contract Details

Approval Date

10/15/2021

Contract Begin Date

10/27/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Edgar Bulloch, Interim CEO
(760) 767-6641

Contract Pharmacy Representative

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

Signed By Date

10/15/2021

340B Drug Pricing Program Database