Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09047Q GOLDEN VALLEY HEALTH CENTER

Covered Entity Details

Entity Name

GOLDEN VALLEY HEALTH CENTER

Subdivision Name

GVHC - Ceres

Type

HRSA-Funded Health Center

340B ID

CH09047Q

Entity Address

2760 THIRD STREET
CERES, CA 95307

Grant Number

H80CS00742

Participating Start Date

4/1/2007

Last Recertification Date

2/9/2024

Entity Termination Date

4/1/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09884
2601 OAKDALE RD STE E
MODESTO, CA 95355

Pharmacy Comments

Contract Details

Approval Date

10/16/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

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

340B Drug Pricing Program Database