Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09365AA CLINICAS DEL CAMINO REAL, INC.

Covered Entity Details

Entity Name

CLINICAS DEL CAMINO REAL, INC.

Subdivision Name

Clinicas del Camino Real, Inc. - Simi Valley

Type

HRSA-Funded Health Center

340B ID

CH09365AA

Entity Address

1424 Madera Rd
Simi Valley, CA 93065-3000

Grant Number

H80CS00550

Participating Start Date

10/1/2012

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09556
1740 S VICTORIA AVE
VENTURA, CA 93003

Pharmacy Comments

Contract Details

Approval Date

7/13/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Robert Streeter, Chief Medical Officer
(805) 659-1740

Contract Pharmacy Representative

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

Signed By Date

7/13/2023

340B Drug Pricing Program Database