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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH090470 GOLDEN VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
GOLDEN VALLEY HEALTH CENTERS
Subdivision Name
GVHC - MERCED SUITES
Type
HRSA-Funded Health Center
340B ID
CH090470
Entity Address
847 W. CHILDS AVE
MERCED, CA 95341-6862
Grant Number
H80CS00742
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09866
1190 N MAIN ST
MANTECA, CA 95336
Pharmacy Comments
Contract Details
Approval Date
7/13/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2022
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