Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
FQHC638017 SANTA YNEZ TRIBAL HEALTH CLINIC

Covered Entity Details

Entity Name

SANTA YNEZ TRIBAL HEALTH CLINIC

Subdivision Name

Type

Tribal Contract/Compact with IHS (P.L. 93-638)

340B ID

FQHC638017

Entity Address

90 VIA JUANA LANE
SANTA YNEZ, CA 93460

Grant Number

Participating Start Date

1/1/1995

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09782
610 WEST TEFFT STREET
NIPOMO, CA 93444

Pharmacy Comments

1/15/2010 - STORE NAME CHANGED FROM LONGS DRUG STORES (DBA CVS #9782)

Contract Details

Approval Date

7/13/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Preston Pete, Finance Director
(805) 694-2640

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