Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
STD95503 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

Planned Parenthood Eureka

Type

Sexually Transmitted Diseases

340B ID

STD95503

Entity Address

3225 Timber Fall Ct.
Suite B
Eureka, CA 95503

Grant Number

1H25PS005127

Participating Start Date

4/1/2015

Last Recertification Date

5/6/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09681
1105 MYRTLE AVE
EUREKA, CA 95501

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