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GARFIELD BEACH CVS, L.L.C.
STD921111 Planned Parenthood of the Pacific Southwest
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Covered Entity Details
Entity Name
Planned Parenthood of the Pacific Southwest
Subdivision Name
Kearny Mesa
Type
Sexually Transmitted Diseases
340B ID
STD921111
Entity Address
7035 Convoy Court
San Diego, CA 92111
Grant Number
1H25PS005127
Participating Start Date
1/1/2016
Last Recertification Date
5/21/2024
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 17668
17170 CAMINO DEL SUR
SAN DIEGO, CA 92127
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
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
4/15/2022
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