Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
CH09071AQ COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Subdivision Name

COMMUNITY HEALTH CENTERS BROADWAY DENTAL

Type

HRSA-Funded Health Center

340B ID

CH09071AQ

Entity Address

210 N Broadway
Santa Maria, CA 93454-4415

Grant Number

H80CS00621

Participating Start Date

1/1/2016

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09782
610 WEST TEFFT STREET
NIPOMO, CA 93444

Pharmacy Comments

1/15/2010 - STORE NAME CHANGED FROM LONGS DRUG STORES (DBA CVS #9782)

Contract Details

Approval Date

5/5/2023

Contract Begin Date

5/8/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Business decision by covered entity and/or pharmacy

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

5/5/2023

340B Drug Pricing Program Database