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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09534F Altura Centers for Health
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Covered Entity Details
Entity Name
Altura Centers for Health
Subdivision Name
Altura Centers for Health Administration
Type
HRSA-Funded Health Center
340B ID
CH09534F
Entity Address
1201 N Cherry St
Tulare, CA 93274-2233
Grant Number
H80CS00338
Participating Start Date
10/1/2014
Last Recertification Date
2/2/2024
Entity Termination Date
10/1/2024
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09500
1455 E NOBLE AVE
VISALIA, CA 93292
Pharmacy Comments
Contract Details
Approval Date
7/1/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
GRACIELA Soto Perez, CEO
(559) 685-4601
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/1/2024
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