Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09365AN CLINICAS DEL CAMINO REAL, INC.

Covered Entity Details

Entity Name

CLINICAS DEL CAMINO REAL, INC.

Subdivision Name

Roberto S. Juarez Health Center

Type

HRSA-Funded Health Center

340B ID

CH09365AN

Entity Address

2100 Statham Blvd
Oxnard, CA 93033-3901

Grant Number

H80CS00550

Participating Start Date

4/1/2023

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09286
581 W CHANNEL ISLANDS BLVD
PORT HUENEME, CA 93041

Pharmacy Comments

01/27/2012 changed CP name (was LONGS DRUGS #286)

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