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LONGS DRUG STORES CALIFORNIA, L.L.C.
CHC10607-05 Comprehensive Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Comprehensive Community Health Centers, Inc.
Subdivision Name
Comprehensive Community Health Center - Arleta
Type
HRSA-Funded Health Center
340B ID
CHC10607-05
Entity Address
9043 Woodman Avenue STE C
Arleta, CA 91331-6493
Grant Number
H80CS10607
Participating Start Date
10/1/2023
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09527
12100 VENTURA BLVD
STUDIO CITY, CA 91604
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
FLORA POLADYAN, COO
(818) 630-6106
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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