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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09099N WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
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Covered Entity Details
Entity Name
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Subdivision Name
Nanakuli High & Intermediate School
Type
HRSA-Funded Health Center
340B ID
CH09099N
Entity Address
89-980 Nanakuli Avenue
Waianae, HI 96792
Grant Number
H80CS00807
Participating Start Date
1/1/2019
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #7107
89-102 FARRINGTON HWY, UNIT 4
WAIANAE, HI 96792
Pharmacy Comments
Contract Details
Approval Date
7/2/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RICHARD BETTINI, President & CEO
(808) 697-3300
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/2/2024
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