Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC26625-01 SANTA BARBARA NEIGHBORHOOD CLINICS

Covered Entity Details

Entity Name

SANTA BARBARA NEIGHBORHOOD CLINICS

Subdivision Name

Goleta Neighborhood Dental Clinic

Type

HRSA-Funded Health Center

340B ID

CHC26625-01

Entity Address

164 Kinman Ave.
Ste A
Goleta, CA 93117-3481

Grant Number

H80CS26625

Participating Start Date

10/1/2016

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09394
4852 S BRADLEY RD
SANTA MARIA, CA 93455

Pharmacy Comments

Contract Details

Approval Date

10/17/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Mahdi Ashrafian, Chief Executive Officer
(805) 324-8319

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/17/2022

340B Drug Pricing Program Database