Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09047AJ Golden Valley Health Centers

Covered Entity Details

Entity Name

Golden Valley Health Centers

Subdivision Name

GVHC - TURLOCK PEDIATRIC HEALTH CENTER 1199 Suite 2

Type

HRSA-Funded Health Center

340B ID

CH09047AJ

Entity Address

1199 Delbon Ave Ste 2
Turlock, CA 95382-2006

Grant Number

H80CS00742

Participating Start Date

7/1/2018

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09171
2900 STANDIFORD AVE
MODESTO, CA 95350

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

340B Drug Pricing Program Database