Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH097180 PEACH TREE CLINIC, THE, INC.

Covered Entity Details

Entity Name

PEACH TREE CLINIC, THE, INC.

Subdivision Name

Peach Tree Clinic, Inc

Type

HRSA-Funded Health Center

340B ID

CH097180

Entity Address

5730 Packard Ave., STE 500
Marysville, CA 95901-7119

Grant Number

H80CS06629

Participating Start Date

1/1/2008

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09322
2085 FAIR OAKS BLVD
SACRAMENTO, CA 95825

Pharmacy Comments

Contract Details

Approval Date

7/3/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Greg Stone, CEO
(530) 741-6245 Ext: 1363

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/3/2024

340B Drug Pricing Program Database