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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09071AT 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
CHC - SANTA MARIA HIGH SCHOOL
Type
HRSA-Funded Health Center
340B ID
CH09071AT
Entity Address
829 S LINCOLN ST, SPC 908
SANTA MARIA, CA 93458
Grant Number
H80CS00621
Participating Start Date
7/1/2016
Last Recertification Date
1/30/2023
Entity Termination Date
4/1/2024
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
6/9/2023
Contract Begin Date
6/9/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
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
6/9/2023
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