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GARFIELD BEACH CVS, L.L.C.
CH099010 BORREGO COMMUNITY HEALTH FOUNDATION
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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
CVS PHARMACY # 16053
3520 TYLER ST
RIVERSIDE, CA 92503
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/27/2023
Business decision by covered entity and/or pharmacy
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
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