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LONGS DRUG STORES CALIFORNIA, L.L.C.
CAH051321-00 NorCal HealthConnect LLC- DBA Healdsburg Hospital
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Covered Entity Details
Entity Name
NorCal HealthConnect LLC- DBA Healdsburg Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051321-00
Entity Address
1375 UNIVERSITY AVENUE
HEALDSBURG, CA 95448
Medicare Provider Number
051321
Participating Start Date
8/23/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09931
9030 BROOKS RD S
WINDSOR, CA 95492
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patti Pilgrim, Regional CFO
(707) 525-5323
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2022
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