Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
CH09071L 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 GUADALUPE

Type

HRSA-Funded Health Center

340B ID

CH09071L

Entity Address

4723 W MAIN ST, STE H.
GUADALUPE, CA 93434

Grant Number

H80CS00621

Participating Start Date

1/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09662
3960 BROAD STREET
SAN LUIS OBISPO, CA 93401

Pharmacy Comments

01/15/2010 - STORE NAME CHANGED FROM LONGS DRUG STORES (DBA - CVS #9662)

Contract Details

Approval Date

6/9/2023

Contract Begin Date

6/9/2023

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

6/9/2023

340B Drug Pricing Program Database