Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
DSH050599 UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER

Covered Entity Details

Entity Name

UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050599

Entity Address

2315 STOCKTON BLVD
SACRAMENTO, CA 95817

Medicare Provider Number

050599

Participating Start Date

1/1/1999

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY #17822
1707 J STREET
SACRAMENTO, CA 95811

Pharmacy Comments

Contract Details

Approval Date

7/11/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/27/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Cheryl Ann Sadro, Chief Financial Officer
(916) 703-5009

Contract Pharmacy Representative

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

Signed By Date

7/11/2023

340B Drug Pricing Program Database