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GARFIELD BEACH CVS, L.L.C.
CHC24113-02 ELICA HEALTH CENTERS
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Covered Entity Details
Entity Name
ELICA HEALTH CENTERS
Subdivision Name
Elica Health Centers - Midtown Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC24113-02
Entity Address
3701 J St Ste 100
Sacramento, CA 95816
Grant Number
H80CS24113
Participating Start Date
1/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 5225
2636 MARCONI AVE.
SACRAMENTO, CA 95821
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David E Hughes, COO/CFO
(916) 569-8484 Ext: 312
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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