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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09364AT Family Healthcare Network
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Covered Entity Details
Entity Name
Family Healthcare Network
Subdivision Name
Family HealthCare Network - Fresno Shields
Type
HRSA-Funded Health Center
340B ID
CH09364AT
Entity Address
3505 E Shields Ave
Fresno, CA 93726-6910
Grant Number
H80CS00786
Participating Start Date
4/1/2020
Last Recertification Date
2/16/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09893
2539 N 11TH AVE
HANFORD, CA 93230
Pharmacy Comments
Contract Details
Approval Date
7/13/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
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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