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LONGS DRUG STORES CALIFORNIA, L.L.C.
DSH050496 JOHN MUIR MEDICAL CENTER - CONCORD
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Covered Entity Details
Entity Name
JOHN MUIR MEDICAL CENTER - CONCORD
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050496
Entity Address
2540 EAST STREET
CONCORD, CA 94520
Medicare Provider Number
050496
Participating Start Date
1/1/2023
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 4326
4028 LONE TREE WAY
ANTIOCH, CA 94531
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Zach Harris, VP Ancillary Services
(808) 457-0157
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/14/2023
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