Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09071AN COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Subdivision Name

CHC - MOBILE MEDICAL VAN 2

Type

HRSA-Funded Health Center

340B ID

CH09071AN

Entity Address

200 W. WILLIAMS ST
SANTA MARIA, CA 93458-1704

Grant Number

H80CS00621

Participating Start Date

10/1/2015

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09892
827 OAK PARK BLVD
PISMO BEACH, CA 93449

Pharmacy Comments

Contract Details

Approval Date

10/13/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

RONALD E. CASTLE, CEO
(805) 459-1835

Contract Pharmacy Representative

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

Signed By Date

10/13/2023

340B Drug Pricing Program Database