Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH091963G LIVINGSTON COMMUNITY HEALTH

Covered Entity Details

Entity Name

LIVINGSTON COMMUNITY HEALTH

Subdivision Name

Livingston Community Health Campus, B Street, Buildings A, B, C

Type

HRSA-Funded Health Center

340B ID

CH091963G

Entity Address

600 B Street BLDG A, B, C
Livingston, CA 95334-9593

Grant Number

H80CS02588

Participating Start Date

7/1/2019

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09171
2900 STANDIFORD AVE
MODESTO, CA 95350

Pharmacy Comments

Contract Details

Approval Date

4/20/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Leslie Abasta-Cummings, CEO
(209) 850-3545

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/20/2022

340B Drug Pricing Program Database