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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09047AA GOLDEN VALLEY HEALTH CENTERS
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Covered Entity Details
Entity Name
GOLDEN VALLEY HEALTH CENTERS
Subdivision Name
GVHC - Empire
Type
HRSA-Funded Health Center
340B ID
CH09047AA
Entity Address
198 N. G Street
Empire, CA 95319
Grant Number
H80CS00742
Participating Start Date
4/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09308
901 N CARPENTER RD STE 30
MODESTO, CA 95351
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
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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