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LONGS DRUG STORES CALIFORNIA, L.L.C.
URB12040D Native American Health Center
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Covered Entity Details
Entity Name
Native American Health Center
Subdivision Name
Alameda High School
Type
Urban Indian
340B ID
URB12040D
Entity Address
2201 Encinal Ave.
Alameda, CA 94501
Grant Number
Participating Start Date
10/1/2014
Last Recertification Date
2/12/2025
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
1/27/2022
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
1/27/2022
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