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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09071AS COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Subdivision Name
Community Health Centers Los Alamos
Type
HRSA-Funded Health Center
340B ID
CH09071AS
Entity Address
490 Bell St
Ste 103
Los Alamos, CA 93440
Grant Number
H80CS00621
Participating Start Date
7/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09892
827 OAK PARK BLVD
PISMO BEACH, CA 93449
Pharmacy Comments
Contract Details
Approval Date
5/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/5/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
5/4/2023
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