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LONGS DRUG STORES CALIFORNIA, L.L.C.
STD95482 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
UKIAH CENTER
Type
Sexually Transmitted Diseases
340B ID
STD95482
Entity Address
242-A Hospital Drive
UKIAH, CA 95482
Grant Number
1H25PS005127
Participating Start Date
7/1/2014
Last Recertification Date
5/23/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09822
155 ORCHARD PLZ
UKIAH, CA 95482
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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