Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
URB12040 NATIVE AMERICAN HEALTH CENTER

Covered Entity Details

Entity Name

NATIVE AMERICAN HEALTH CENTER

Subdivision Name

DBA NATIVE AMERICAN HEALTH CENTER

Type

Urban Indian

340B ID

URB12040

Entity Address

3124 INTERNATIONAL BLVD.
OAKLAND, CA 94601

Grant Number

Participating Start Date

12/1/1992

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09553
4349 SAN PABLO AVE
EMERYVILLE, CA 94608

Pharmacy Comments

Contract Details

Approval Date

1/14/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/30/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Greg C Garrett, Chief Operating Officer
(510) 485-5902

Contract Pharmacy Representative

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

Signed By Date

1/14/2022

340B Drug Pricing Program Database