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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09364R FAMILY HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
FAMILY HEALTHCARE NETWORK
Subdivision Name
Family HealthCare Network-Traver Health Center
Type
HRSA-Funded Health Center
340B ID
CH09364R
Entity Address
4177 Avenue 368
Traver, CA 93673
Grant Number
H80CS00786
Participating Start Date
4/1/2016
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09176
1395 E PROSPERITY AVE
TULARE, CA 93274
Pharmacy Comments
Contract Details
Approval Date
7/13/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2024
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