340B Drug Pricing Program Database

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Effective Sunday, September 1, OPA is implementing a change to the export format for Medicaid and NPI numbers. This change affects covered entity exports that include Medicaid and/or NPI billing numbers, and the CE Daily Report in Excel format. If the number is associated with more than one state, all the states will be listed between one set of parentheses following the number - for example, 1275575227 (IN,MI,OH). This change is necessary to ensure that the exported data does not exceed Excel’s limit for field length.

LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHC638549 mathiesen memorial Health Clinic

Covered Entity Details

Tribal Contract/Compact with IHS (P.L. 93-638)
FQHC638549
18144 Seco Street
Jamestown, CA 95327
4/1/2018
2/12/2024


Pharmacy Details

DBA: CVS/PHARMACY # 09933
1405 HERNDON AVENUE
CLOVIS, CA 93611

Contract Details

4/4/2022
7/1/2022


Contacts


John Richard Vass, CEO
(209) 984-4827 Ext: 2099844827



CVS Health
Christian J Reid, Sr. Director, 340B
(401) 770-2118
4/4/2022