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GARFIELD BEACH CVS, L.L.C.
CAH051335-00 BEAR VALLEY COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
BEAR VALLEY COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051335-00
Entity Address
41870 GARSTIN DR
BIG BEAR, CA 92315
Medicare Provider Number
051335
Participating Start Date
7/1/2022
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09739
42136 BIG BEAR BLVD/PO BOX 6966
BIG BEAR LAKE, CA 92315
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Evan Rayner, CEO
(909) 878-8214
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2022
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