Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
STD94590 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

VALLEJO CENTER

Type

Sexually Transmitted Diseases

340B ID

STD94590

Entity Address

303 Sacramento Street
VALLEJO, CA 94590

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 # 09832
3678 SONOMA BLVD
VALLEJO, CA 94590

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