Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09365AM Clinicas del Camino Real, Inc.

Covered Entity Details

Entity Name

Clinicas del Camino Real, Inc.

Subdivision Name

Clinicas del Camino Real Inc - Newbury Park Optical

Type

HRSA-Funded Health Center

340B ID

CH09365AM

Entity Address

1000 Newbury Rd Ste 170
Newbury Park, CA 91320-6439

Grant Number

H80CS00550

Participating Start Date

4/1/2021

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09151
600 W MAIN ST
SANTA PAULA, CA 93060

Pharmacy Comments

01/27/2012 changed CP name (was LONGS DRUGS #151)

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