Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC26623-02 OPERATION SAMAHAN

Covered Entity Details

Entity Name

OPERATION SAMAHAN

Subdivision Name

OPSAM HEALTH: 10737 Camino Ruiz Ste. 235

Type

HRSA-Funded Health Center

340B ID

CHC26623-02

Entity Address

10737 Camino Ruiz STE 235
San Diego, CA 92126-2375

Grant Number

H80CS26623

Participating Start Date

4/1/2014

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09251
3999 SANTA RITA ROAD
PLEASANTON, CA 94588

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

Elidoro Primero, Executive Director
(844) 200-2426 Ext: 1071

Contract Pharmacy Representative

CVS Pharmacies
Christian Reid, 340B Program Director
(401) 770-2118

Signed By Date

4/15/2022

340B Drug Pricing Program Database