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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH0923660 EL DORADO COUNTY COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
EL DORADO COUNTY COMMUNITY HEALTH CENTER
Subdivision Name
EL DORADO COUNTY COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0923660
Entity Address
4212 Missouri Flat Road
Placerville, CA 95667-6269
Grant Number
H80CS06671
Participating Start Date
1/1/2007
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09233
515 S STATE HIGHWAY 49
JACKSON, CA 95642
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
Judy Stein, CFO
(530) 748-2327
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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