Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHC638012B NORTHERN VALLEY INDIAN HEALTH

Covered Entity Details

Entity Name

NORTHERN VALLEY INDIAN HEALTH

Subdivision Name

Type

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

340B ID

FQHC638012B

Entity Address

2500 N MAIN STREET
RED BLUFF, CA 96080

Grant Number

Participating Start Date

4/1/2011

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 07128
2780 ESPLANADE
CHICO, CA 95973

Pharmacy Comments

Contract Details

Approval Date

7/17/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Inder Wadhwa, CEO
(530) 896-9409

Contract Pharmacy Representative

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

Signed By Date

7/17/2023

340B Drug Pricing Program Database