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GARFIELD BEACH CVS, L.L.C.
STD95405 PLANNED PARENTHOOD SHASTA-DIABLO INC. DBA PLANNED PARENTHOOD NORTHERN CALIFORNIA
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Covered Entity Details
Entity Name
PLANNED PARENTHOOD SHASTA-DIABLO INC. DBA PLANNED PARENTHOOD NORTHERN CALIFORNIA
Subdivision Name
SANTA ROSA CENTER
Type
Sexually Transmitted Diseases
340B ID
STD95405
Entity Address
1140 SONOMA AVE
BUILDING #3
SANTA ROSA, CA 95405
Grant Number
1H25PS005127
Participating Start Date
7/1/2014
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16356
1980 SANTA ROSA AVE
SANTA ROSA, CA 95407
Pharmacy Comments
Contract Details
Approval Date
9/2/2022
Contract Begin Date
9/12/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gloria Martinez, Medical Services & Purchasing Manager
(925) 887-5217
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
9/2/2022
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