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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH091100 VALLEY HEALTH TEAM, INC.
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Covered Entity Details
Entity Name
VALLEY HEALTH TEAM, INC.
Subdivision Name
SAN JOAQUIN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH091100
Entity Address
21890 COLORADO AVENUE
SAN JOAQUIN, CA 93660-0737
Grant Number
H80CS00525
Participating Start Date
7/1/1999
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03925
2133 SHAW AVE
CLOVIS, CA 93611
Pharmacy Comments
Contract Details
Approval Date
10/18/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/8/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Soyla Griffin, Chief Executive Officer
(559) 693-2462 Ext: 2943
Contract Pharmacy Representative
Montana CVS Pharmacy, LLC
Christian Reid, Senior Director
(401) 770-2118
Signed By Date
10/18/2021
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