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GARFIELD BEACH CVS, L.L.C.
STD92081 Planned Parenthood of the Pacific Southwest
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Covered Entity Details
Entity Name
Planned Parenthood of the Pacific Southwest
Subdivision Name
Vista
Type
Sexually Transmitted Diseases
340B ID
STD92081
Entity Address
1964 Via Centre Drive
Vista, CA 92081
Grant Number
1H25PS005127
Participating Start Date
1/1/2016
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09610
12280 PERRIS BLVD
MORENO VALLEY, CA 92557
Pharmacy Comments
Contract Details
Approval Date
4/12/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Darrah Johnson, CEO
(619) 881-5050 Ext: 6198815050
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2022
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