340B Drug Pricing Program Database

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09820
444 E SAN YSIDRO BLVD
SAN YSIDRO, CA 92173

Pharmacy Comments

Approval Date

10/14/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/16/2017
Pharmacy closed

Covered Entity Signing Official

Kevin Mattson, President & CEO
(619) 662-6322

Contract Pharmacy Representative

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

Signed By Date

10/14/2015