Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
STD94509 Planned Parenthood: Shasta-Diablo, Inc. DBA Planned Parenthood Northern California

Covered Entity Details

Entity Name

Planned Parenthood: Shasta-Diablo, Inc. DBA Planned Parenthood Northern California

Subdivision Name

ANTIOCH CENTER

Type

Sexually Transmitted Diseases

340B ID

STD94509

Entity Address

1104 BUCHANAN ROAD
#C10
ANTIOCH, CA 94509-4426

Grant Number

1H25PS005127

Participating Start Date

4/1/2004

Last Recertification Date

5/6/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03053
10650 SAN PABLO AVE
EL CERRITO, CA 94530

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

340B Drug Pricing Program Database