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GARFIELD BEACH CVS, L.L.C.
CH0921760 WESTERN SIERRA MEDICAL CLINIC
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Covered Entity Details
Entity Name
WESTERN SIERRA MEDICAL CLINIC
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0921760
Entity Address
209 NEVADA STREET
DOWNIEVILLE, CA 95936
Grant Number
H80CS08234
Participating Start Date
4/1/2007
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16833
10451 FAIRWAY DR
ROSEVILLE, CA 95678
Pharmacy Comments
Contract Details
Approval Date
7/24/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennifer Malone, CEO
(530) 273-3819
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/24/2023
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