Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09167J VISTA COMMUNITY CLINIC

Covered Entity Details

Entity Name

VISTA COMMUNITY CLINIC

Subdivision Name

VCC: The Gary Center

Type

HRSA-Funded Health Center

340B ID

CH09167J

Entity Address

201 S. Harbor Blvd.
La Habra, CA 90631-5654

Grant Number

H80CS00282

Participating Start Date

4/1/2017

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06368
635 S MELROSE DR
VISTA, CA 92081

Pharmacy Comments

Contract Details

Approval Date

7/15/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Michele Lambert, CFO
(760) 216-5803

Contract Pharmacy Representative

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

Signed By Date

7/15/2024

340B Drug Pricing Program Database