Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
DSH050108 SUTTER VALLEY HOSPITALS DBA SUTTER MEDICAL CENTER SACRAMENTO

Covered Entity Details

Entity Name

SUTTER VALLEY HOSPITALS DBA SUTTER MEDICAL CENTER SACRAMENTO

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050108

Entity Address

2825 Capitol Avenue
SACRAMENTO, CA 95816

Medicare Provider Number

050108

Participating Start Date

4/1/2006

Last Recertification Date

8/14/2024

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09322
2085 FAIR OAKS BLVD
SACRAMENTO, CA 95825

Pharmacy Comments

Contract Details

Approval Date

10/19/2022

Contract Begin Date

11/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/27/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Timothy J. Noakes, CFO
(916) 887-4500

Contract Pharmacy Representative

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

Signed By Date

10/19/2022

340B Drug Pricing Program Database