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LONGS DRUG STORES CALIFORNIA, L.L.C.
URB12040A Urban Indian Health Board DBA Native American Health Center
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Covered Entity Details
Entity Name
Urban Indian Health Board DBA Native American Health Center
Subdivision Name
San Francisco Clinic
Type
Urban Indian
340B ID
URB12040A
Entity Address
160 Capp Street
San Francisco, CA 94110
Grant Number
Participating Start Date
10/1/2013
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07955
2025 VAN NESS AVE
SAN FRANCISCO, CA 94109
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
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
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