Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH090780 Community Medical Centers, Inc.

Covered Entity Details

Entity Name

Community Medical Centers, Inc.

Subdivision Name

Community Medical Centers, Channel

Type

HRSA-Funded Health Center

340B ID

CH090780

Entity Address

701 E Channel St.
Stockton, CA 95202-2628

Grant Number

H80CS00138

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09830
6632 PACIFIC AVENUE
STOCKTON, CA 95207

Pharmacy Comments

Contract Details

Approval Date

7/9/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Christine Noguera, CEO
(209) 373-2826

Contract Pharmacy Representative

CVS Caremark
JACKLYN PARFITT, MANAGER, PAYER RELATIONS
(401) 770-6467

Signed By Date

7/9/2015

340B Drug Pricing Program Database